Individual
MR. JAMIE WILSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4300 52ND AVE S, SAINT PETERSBURG, FL 33711-4694
(727) 488-8944
Mailing address
4300 52ND AVE S, SAINT PETERSBURG, FL 33711-4694
(727) 488-8944
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA9303
FL
Other
Enumeration date
08/27/2016
Last updated
08/27/2016
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