Individual
CHRISTINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4725 WHITESBURG DR S, STE 201, HUNTSVILLE, AL 35802-1665
(256) 880-7776
Mailing address
397 JAMES FRAZIER RD, LACEYS SPRING, AL 35754-7312
(256) 778-0436
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 3643
LICENSE #
AL
Enumeration date
08/30/2006
Last updated
07/08/2007
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