Individual
BRETT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6106 HEALTH CENTER LN, FREDERICKSBURG, VA 22407-6687
(540) 785-1103
Mailing address
6106 HEALTH CENTER LN, FREDERICKSBURG, VA 22407-6687
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603167
VA
225200000X
Physical Therapy Assistant
66009042
NY
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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