Individual
SHELBY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3446 MCKELVEY RD, BRIDGETON, MO 63044-2525
(314) 298-0353
Mailing address
1077 DARWICK CT, SAINT LOUIS, MO 63132-2909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2019023498
MO
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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