Individual
MELISSA ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7120 CORBIN AVE, RESEDA, CA 91335-3618
(818) 881-4540
Mailing address
1856 NW PARK TER, ALBANY, OR 97321-1264
(541) 974-9744
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
08934
OR
225200000X
Physical Therapy Assistant
Primary
AT10727
CA
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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