Individual
WENDY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 S MAIN ST, ROSWELL, NM 88203-5436
(575) 623-6008
Mailing address
5625 N RED OAK DR, GREENFIELD, IN 46140-8757
(765) 524-2407
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06001423A
IN
Other
Enumeration date
01/26/2011
Last updated
01/26/2011
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