Individual
MRS. LISA MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1468 NORWOOD DR, SAINT CHARLES, MO 63303-3318
(314) 440-0086
(636) 949-0465
Mailing address
1468 NORWOOD DR, SAINT CHARLES, MO 63303-3318
(314) 440-0086
(636) 949-0465
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01636
MO
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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