Individual
ELLI LYNN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
5060 DAVIS BLVD, NORTH RICHLAND HILLS, TX 76180-7004
(817) 498-8585
Mailing address
2500 BENNETT AVE APT 1234, DALLAS, TX 75206-7181
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3128102
TX
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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