Individual
DANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1025 VERDAE BLVD STE E, GREENVILLE, SC 29607-4032
(843) 972-0940
(843) 881-8452
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6764
SC
Other
Enumeration date
07/16/2012
Last updated
07/21/2022
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