Individual
RONALD SHANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1050 N JAMES M CAMPBELL BLVD STE 200, COLUMBIA, TN 38401-2754
(931) 381-2663
(931) 490-1369
Mailing address
PO BOX 306556, NASHVILLE, TN 37230-6556
(865) 243-8153
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2988
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q013494
—
TN
Enumeration date
10/19/2006
Last updated
10/12/2023
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