Individual
MEGAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
615 N PROMENADE ST, HAVANA, IL 62644-1243
(309) 543-8461
(309) 543-8114
Mailing address
615 N PROMENADE ST, P.O. BOX 530, HAVANA, IL 62644-1243
(309) 543-8461
(309) 543-8114
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003371
IL
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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