Individual
ELAINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1628 19TH ST, LUBBOCK, TX 79401-4832
(806) 219-0500
(806) 766-1286
Mailing address
1628 19TH ST, LUBBOCK, TX 79401-4832
(806) 219-0500
(806) 766-1286
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1099992
TX
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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