Individual
MICHAEL D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
7406 HIGHWAY 1 STE 102, MANSURA, LA 71350-4204
(318) 240-7680
(318) 240-7681
Mailing address
619 N MAIN ST, JENNINGS, LA 70546-5347
(337) 824-8287
(337) 824-8290
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10574
LA
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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