Individual
JENNIFER C WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6 E PALO VERDE ST STE 13, GILBERT, AZ 85296-1020
(602) 363-4633
Mailing address
6 E PALO VERDE ST STE 13, GILBERT, AZ 85296-1020
(602) 363-4633
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5265
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624917
—
AZ
Enumeration date
03/30/2007
Last updated
12/27/2015
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