Individual
MS. AMANDA C WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1135 NW 23RD AVE, SUITE D, GAINESVILLE, FL 32609-5415
(352) 328-8744
Mailing address
5226 NW 57TH LN, GAINESVILLE, FL 32653-3320
(352) 328-8744
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA46048
FL
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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