Individual
HALEY NICOLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2861 NE INDEPENDENCE AVE STE 104, LEES SUMMIT, MO 64064-2379
(816) 272-8538
Mailing address
2861 NE INDEPENDENCE AVE, STE 104, LEES SUMMIT, MO 64064-2379
(816) 272-8538
(816) 272-8539
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-06896
KS
225100000X
Physical Therapist
Primary
2021037851
MO
Other
Enumeration date
09/23/2021
Last updated
01/14/2022
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