Individual
JOLYNA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
366 LAKESHORE DR, LAKESIDE, MT 59922-9712
(303) 475-2504
Mailing address
366 LAKESHORE DR, LAKESIDE, MT 59922-9712
(303) 475-2504
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19503
MT
Other
Enumeration date
03/29/2021
Last updated
03/29/2021
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