Individual
JENNIFER LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1350 SULLIVAN AVE, SOUTH WINDSOR, CT 06074-2760
(860) 697-6472
(860) 648-2876
Mailing address
73 NEWTON RD, STE 101, PLAISTOW, NH 03865-2424
(978) 388-7272
(978) 388-7373
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006894
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004219441
—
CT
Enumeration date
08/13/2006
Last updated
06/25/2015
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