Individual
MRS. SHANNON LEIGH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5210 SARAH LANE, FREDERICKSBURG, VA 22407
(540) 891-7434
Mailing address
5210 SARAH LANE, FREDERICKSBURG, VA 22407
(540) 891-7434
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306001800
VA
Other
Enumeration date
06/07/2007
Last updated
07/08/2007
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