Individual
MRS. STEPHANIE ANN WILKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
8080 BLUEBONNET BLVD, SUITE 1000, BATON ROUGE, LA 70810-7827
(225) 924-2424
(225) 408-7984
Mailing address
8080 BLUEBONNET BLVD, SUITE 1000, BATON ROUGE, LA 70810-7827
(225) 924-2424
(225) 408-7984
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
07928
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07928
LA PT LICENSE
LA
Enumeration date
08/21/2012
Last updated
08/26/2012
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