Individual
MS. SUMMER ROSE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Contact information
Practice address
1713 ALVAR ST, NEW ORLEANS, LA 70117-5128
(512) 636-6989
Mailing address
1713 ALVAR ST, NEW ORLEANS, LA 70117-5128
(512) 636-6989
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200277
LA
Other
Enumeration date
05/06/2009
Last updated
10/07/2022
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