Individual
DANIEL CHASE WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC,LAT
Contact information
Practice address
1230 CLAYTON AVE, TUPELO, MS 38804-1825
(662) 416-6094
Mailing address
1230 CLAYTON AVE, TUPELO, MS 38804-1825
(662) 416-6094
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0737
MS
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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