Provider Demographics
NPI:1588921753
Name:WILHELM, JAMIE LYNN (DPT)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYNN
Last Name:WILHELM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:ZERWEKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6301 FOREST HILLS DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4137
Mailing Address - Country:US
Mailing Address - Phone:505-823-8350
Mailing Address - Fax:505-923-5587
Practice Address - Street 1:6301 FOREST HILLS DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4137
Practice Address - Country:US
Practice Address - Phone:505-823-8350
Practice Address - Fax:505-923-5587
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist