Individual
MS. DEBORAH MAE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3409 26TH ST W, BRADENTON, FL 34205-3600
(941) 751-7338
Mailing address
638 LA PLAZA AVE S, ST PETERSBURG, FL 33707-2224
(727) 384-0010
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA15713
FL
Other
Enumeration date
03/14/2008
Last updated
04/09/2008
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