Individual
GRETTEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
454 NW 22ND AVE STE 108, MIAMI, FL 33125-3355
(305) 890-9691
Mailing address
4361 SW 146TH CT, MIAMI, FL 33175-6810
(786) 955-5835
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29845
FL
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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