Individual
AUDREY J WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
211 E STADIUM, MAGNOLIA, AR 71753-2032
(870) 234-7604
Mailing address
22 LAFAYETTE 243, TAYLOR, AR 71861-8825
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2194
AR
225200000X
Physical Therapy Assistant
PTA6575
LA
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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