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Individual
KENDELL SCOTT WILSON
Active
Individual
KENDELL SCOTT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225400000X
Rehabilitation Practitioner
—
—
2255A2300X
Athletic Trainer
—
—
227900000X
Registered Respiratory Therapist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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