Individual
HEATHER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
13 OAK DR, HAMILTON, NY 13346-1338
(315) 228-6399
Mailing address
1348 POOLVILLE RD, EARLVILLE, NY 13332-3133
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
NY
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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