Individual
MS. STEPHANIE RENEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3146 S US HIGHWAY 117, MAGNOLIA, NC 28453-8974
(910) 271-2240
Mailing address
3146 S US HIGHWAY 117, MAGNOLIA, NC 28453-8974
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5163
NC
Other
Enumeration date
07/31/2013
Last updated
07/31/2013
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