Individual
KERRIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 JOHNSON ST, CAVE CITY, AR 72521-9070
(870) 283-5788
Mailing address
119 JOHNSON ST, CAVE CITY, AR 72521-9070
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/25/2015
Last updated
04/25/2015
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