Individual
KELLY WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1360 N LOUISIANA ST STE D, KENNEWICK, WA 99336-7171
(509) 735-4247
Mailing address
1360 N LOUISIANA ST STE D, KENNEWICK, WA 99336-7171
(509) 735-4247
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Enumeration date
03/20/2009
Last updated
03/20/2009
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