Individual
JESSICA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1029 YORK ST NE, AIKEN, SC 29801-4025
(803) 502-1484
(803) 502-1485
Mailing address
PO BOX 749303, ATLANTA, GA 30374-9306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7928
SC
225100000X
Physical Therapist
PT024720
PA
Other
Enumeration date
11/14/2016
Last updated
11/12/2024
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