Individual
JUSTIN WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1580 N FIESTA BLVD, SUITE 102, GILBERT, AZ 85233-1032
(480) 892-7986
Mailing address
1580 N FIESTA BLVD, SUITE 102, GILBERT, AZ 85233-1032
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7191
AZ
Other
Enumeration date
05/16/2006
Last updated
07/08/2007
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