Individual
ELIZA JEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7235 N 185TH AVE, WADDELL, AZ 85355-9812
(623) 695-1973
Mailing address
7235 N 185TH AVE, WADDELL, AZ 85355-9812
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
AZ
Other
Enumeration date
06/30/2017
Last updated
06/30/2017
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