Individual
THEO WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
16 AVERY HTS, HARTFORD, CT 06106-4201
(347) 490-4333
Mailing address
16 AVERY HTS, HARTFORD, CT 06106-4201
(347) 490-4333
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008444
CT
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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