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Individual

ASHLEIGH WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5656 S ONAGA PL, BOISE, ID 83716-6865
(806) 674-5736
Mailing address
5656 S ONAGA PL, BOISE, ID 83716-6865
(806) 674-5736

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6573
ID
225100000X
Physical Therapist
2251P0200X
Pediatric Physical Therapist
1191421
TX

Other

Enumeration date
01/31/2015
Last updated
12/26/2019
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