Individual
PAMELA K WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8610 117TH ST, RICHMOND HILL, NY 11418-1708
(917) 603-2422
Mailing address
8610 117TH ST, RICHMOND HILL, NY 11418-1708
(917) 603-2422
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
014427-1
NY
Other
Enumeration date
06/14/2009
Last updated
06/14/2009
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