Individual
MS. JAMIE SUEANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
240 HARWOOD RD STE 3, BEDFORD, TX 76021-4189
(817) 680-3873
Mailing address
6824 MEADOWBROOK DR, FORT WORTH, TX 76112-5245
(817) 680-3873
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT129780
TX
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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