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Individual

JESSICA WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
10301 KANIS RD, LITTLE ROCK, AR 72205-6205
(501) 604-6900
Mailing address
10301 KANIS RD, LITTLE ROCK, AR 72205-6205
(501) 604-6900

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT762
AR

Other

Enumeration date
11/18/2016
Last updated
11/18/2016
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