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Individual

VICTORIA KALENE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
801 MACARTHUR BLVD STE 405, MUNSTER, IN 46321-2919
(219) 836-4461
Mailing address
13740 N AYRSHIRE CIR, CAMBY, IN 46113-9635
(317) 292-2014

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
05/13/2018
Last updated
05/13/2018
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