Individual
GEORGIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
605 WASHINGTON ST, FAYETTE, IA 52142-9206
(563) 425-5200
Mailing address
605 WASHINGTON ST, FAYETTE, IA 52142-9206
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
133185
IA
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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