Individual
ALEXIS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
409 CRYSTALWOOD COURT NW, CONCORD, NC 28027-2200
(434) 234-2184
Mailing address
409 CRYSTALWOOD COURT NW, CONCORD, NC 28027-2200
(434) 234-2184
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
04/01/2021
Last updated
04/01/2021
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