Individual
DAWN WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-6267
(618) 256-7931
Mailing address
8816 MANCHESTER RD, #318, BRENTWOOD, MO 63144-2602
(618) 256-7962
(618) 256-1660
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1042059
TX
Other
Enumeration date
01/11/2006
Last updated
07/08/2007
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