Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackie Wilmoth

Individual provider Physical Therapy Assistant · NPI 1255679155

Jackie Wilmoth is a Physical Therapy Assistant in Winston Salem, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2013

Practice location Address checks out

849 Waterworks Rd
Winston Salem, NC 27101-1956
Phone: (336) 595-2166
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence A4893 (NC)

Record details

NPI number1255679155
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 28, 2013
Last updated in NPPESJanuary 28, 2013

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