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Individual

ASHLEY WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
2911 GEORGE BUSBEE PKWY NW, #50, KENNESAW, GA 30144-6908
(844) 328-4624
Mailing address
5256 OLDE MILL DR NE, WOODSTOCK, GA 30188-4059
(770) 500-8079

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003307
GA

Other

Enumeration date
03/14/2016
Last updated
03/14/2016
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