Individual
BRANDON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1424 MONTCLAIR RD, IRONDALE, AL 35210-2208
(800) 381-0822
Mailing address
8477 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(800) 381-0822
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA10940
AL
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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