Individual
MRS. JULIA B WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4157 S HARVARD AVE, #111, TULSA, OK 74135-2631
(918) 712-7868
(918) 749-2901
Mailing address
4157 S HARVARD AVE, #111, TULSA, OK 74135-2631
(918) 712-7868
(918) 749-2901
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
481
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100663220C
—
OK
05
—
100663220E
—
OK
01
—
10228
BLUE CROSS BLUE SHILED
OK
05
—
200046900B
—
OK
01
—
21824112
AETNA
OK
01
—
4199540
AETNA
OK
Enumeration date
07/18/2005
Last updated
04/24/2008
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