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Individual
MISS KRISTINA SWETLAND WILSON
Active
Individual
MISS KRISTINA SWETLAND WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T., D.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25257
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-6625
MEDICARE ID-TYPE UNSPECIFIED
FL
01
—
4496768
AETNA
FL
01
—
Q08
BCBS OF FL
FL
01
—
Y0M41
BCBS
FL
Enumeration date
05/06/2010
Last updated
08/14/2019
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