Individual
MEGAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2355 S TIBBS AVE, INDIANAPOLIS, IN 46241-4818
(317) 230-4182
Mailing address
5436 LONGWOODS DR, INDIANAPOLIS, IN 46254-4249
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003127A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36003127A
ATHLETIC TRAINER LICENSE
IN
Enumeration date
02/19/2020
Last updated
11/18/2021
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