Individual
ROBERT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 N LOGAN AVE, DANVILLE, IL 61832-3715
(217) 443-3106
(217) 443-3187
Mailing address
801 N LOGAN AVE, DANVILLE, IL 61832-3715
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160001215
IL
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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