Individual
ALEXANDRA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1335 GARWOOD DR, MELBOURNE, FL 32904-1946
(919) 414-8592
Mailing address
1335 GARWOOD DR, MELBOURNE, FL 32904-1946
(919) 414-8592
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA31295
FL
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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