Individual
MR. GRAHAM WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5604 W 74TH ST, INDIANAPOLIS, IN 46278-1752
(317) 290-1551
Mailing address
7482 QUINCY CT, INDIANAPOLIS, IN 46254-9673
(317) 328-2672
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05005594A
IN
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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