Individual
KRISTIN LEEANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
10529 S RIVA RIDGE LOOP, FORT DRUM, NY 13602
(325) 650-6489
(325) 650-6489
Mailing address
99068 MOUNTAIN VIEW DR UNIT A, FORT DRUM, NY 13603-3612
(325) 650-6489
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004899
NY
2255A2300X
Athletic Trainer
6857
TX
Other
Enumeration date
11/15/2017
Last updated
12/22/2025
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