Individual
SHELBY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18205 N 51ST AVE, SUITE 129, GLENDALE, AZ 85308-1490
(623) 398-8554
(623) 398-8278
Mailing address
18205 N 51ST AVE, SUITE 129, GLENDALE, AZ 85308-1490
(623) 398-8554
(623) 398-8278
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5768
AZ
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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