Individual
KATHLEEN R WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
102 WILLIAMS RD, NICHOLASVILLE, KY 40356-1917
(859) 881-0333
Mailing address
235 RIDGEWOOD DR, NICHOLASVILLE, KY 40356-1924
(219) 796-6854
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT816
KY
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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