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Individual
STEVEN JAMES WILSON
Active
Individual
STEVEN JAMES WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT7853
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650025835
RR MEDICARE #
CA
Enumeration date
07/04/2006
Last updated
10/25/2013
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