Individual
MISS SANTANA M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LATC
Contact information
Practice address
275 BATH RD, BRUNSWICK, ME 04011-2671
(207) 729-4998
(207) 729-6225
Mailing address
26A GARDEN ST, BATH, ME 04530-2620
(207) 381-7941
(207) 729-6225
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT363
ME
Other
Enumeration date
01/08/2010
Last updated
01/08/2010
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