Individual
ELISABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
500 E 141ST ST, GLENPOOL, OK 74033-3524
(812) 628-3060
(918) 322-3875
Mailing address
500 E 141ST ST, GLENPOOL, OK 74033-3524
(918) 322-3884
(918) 322-3875
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6306
OK
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
05/30/2023
Last updated
12/16/2024
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