Individual
MS. MARISSA LOUISE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1717 6TH AVENUE SOUTH, ROOM 385 3RD FLOOR, BIRMINGHAM, AL 35294
(205) 975-4922
Mailing address
1717 6TH AVENUE SOUTH, ROOM 385 3RD FLOOR, BIRMINGHAM, AL 35294
(205) 975-4922
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA7640
AL
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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