Individual
AMANDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.A.S. PTA
Contact information
Practice address
924 N SCOTT AVE, BELTON, MO 64012-1739
(816) 331-0111
Mailing address
106 MAVERICK CIR, PECULIAR, MO 64078-9782
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
14-03118
KS
225200000X
Physical Therapy Assistant
Primary
2015027051
MO
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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