Individual
MARIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
355 OAK GROVE RD, SPARTANBURG, SC 29301-2537
(864) 595-4225
(864) 595-4821
Mailing address
556 CHATTOOGA RD, ROEBUCK, SC 29376-3384
(864) 587-7119
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3084
SC
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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