Letitia Wise, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001912 Issued in GA

Practice address

2455 Oak Grove Church Rd
Carrollton, GA 30117-9513

Phone

(770) 834-1737

NPI assigned

Sep 14, 2017

Last updated

Sep 14, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1285153833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5034",
            "city": "KINGSHILL",
            "state": "VI",
            "postal_code": "008515034",
            "telephone_number": "340-473-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 OAK GROVE CHURCH RD",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301179513",
            "telephone_number": "770-834-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "LETITIA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "001912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samory Wilson, RN
• Tracy C Wilson, M.ED.
• Wesley E Wilvert, D.C.
• Tracey J Winter, DPT
• Wise Cracks Chiropractic
• Dayla Deese Wittmeyer
• Terry Wayne Woodard Jr., HOME HEALTH PROVIDER
• Sarah Worley, MPT
• Sarah Elizabeth Worthy, PA
• T. Peter Worthy, DDS

• Physical Therapy Assistant in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.