Individual
MRS. SHELBY I WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
110 W 38TH AVE STE 4A, ANCHORAGE, AK 99503-5677
(907) 561-1478
Mailing address
16451 SAINT JAMES CIRCLE, ANCHORAGE, AK 99516
(907) 336-9353
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1624
AK
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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