Individual
CHANDRA D. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4330 ONONDAGA BLVD, SYRACUSE, NY 13219-3030
(315) 314-1639
(315) 484-9610
Mailing address
20 PEACHTREE CT, SUITE 105, HOLBROOK, NY 11741-4616
(631) 467-3700
(631) 467-0928
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
032989-1
NY
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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