Individual
DOUGLAS K. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1217 S GREELEY HWY STE A, CHEYENNE, WY 82007-3063
(307) 772-0955
(307) 772-0953
Mailing address
1217 S GREELEY HWY STE A, CHEYENNE, WY 82007-3063
(307) 772-0955
(307) 772-0953
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
775
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114493600
—
WY
Enumeration date
03/29/2007
Last updated
06/28/2021
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