Individual
DR. DOMINIQUE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, CLT, CMTPT-DN
Contact information
Practice address
6323 GEORGIA AVE NW # 56167, WASHINGTON, DC 20011-1101
(202) 486-1631
Mailing address
6323 GEORGIA AVE NW # 56167, WASHINGTON, DC 20011-1101
(202) 486-1631
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305207926
VA
225100000X
Physical Therapist
Primary
27058
MD
Other
Enumeration date
01/15/2019
Last updated
10/11/2023
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