Individual
MRS. BRIDGETTE MARIE WILKISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, NCBTMB
Contact information
Practice address
101 NE ROBERTS AVE, GRESHAM, OR 97030-7551
(503) 490-3334
Mailing address
101 NE ROBERTS AVE, GRESHAM, OR 97030-7551
(503) 490-3334
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
18186
OR
Other
Enumeration date
06/21/2011
Last updated
06/21/2011
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