Individual
SHEENA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
581 S SANTA FE TRL, CORNVILLE, AZ 86325-5153
(559) 375-9719
Mailing address
581 S SANTA FE TRL, CORNVILLE, AZ 86325-5153
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000025652
AZ
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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