Individual
CHELSEA GENTZLER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
223 WADSWORTH DR, NORTH CHESTERFIELD, VA 23236-4510
(804) 330-4901
Mailing address
165 WADSWORTH DR, NORTH CHESTERFIELD, VA 23236-4500
(804) 330-4901
(804) 330-9141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/31/2019
Last updated
04/10/2024
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