Individual
MISS KERRY G WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
611 E STAR CT, MONTROSE, CO 81401-6704
(970) 249-1646
(970) 249-8899
Mailing address
611 E STAR CT, MONTROSE, CO 81401-6704
(970) 249-1646
(970) 249-8899
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2447
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64606511
—
CO
Enumeration date
10/12/2005
Last updated
01/24/2012
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