Individual
MRS. SHELIA DIANA WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,PT
Contact information
Practice address
827 WEST SLACK STREET, PEA RIDGE, AR 72751-3703
(479) 644-5166
(479) 488-6220
Mailing address
PO BOX 585, PEA RIDGE, AR 72751-0585
(479) 451-1479
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1625
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129832721
—
AR
01
—
5T483
INSURANCE
AR
Enumeration date
02/13/2007
Last updated
07/29/2010
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