Individual
STEPHANIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 SW 25TH ST, OAK GROVE, MO 64075-9034
(816) 462-5656
Mailing address
202 SW 25TH ST, OAK GROVE, MO 64075-9034
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
34641
FL
Other
Enumeration date
03/30/2026
Last updated
03/30/2026
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