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Individual

MRS. MITSUE ALICE WILCOXSON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
ATC, PT

Contact information

Practice address
900 N UNIVERSITY ST, B63 MACKEY ARENA, PURDUE UNIVERSITY, WEST LAFAYETTE, IN 47907-2070
(765) 494-1703
(765) 494-9899
Mailing address
1709 SUMMIT DR, WEST LAFAYETTE, IN 47906-2229
(765) 497-0849
(765) 494-9899

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
IN
2255A2300X
Athletic Trainer
IN

Other

Enumeration date
06/17/2006
Last updated
09/11/2025
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