Individual
MR. BRIAN TODD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
16542 PROSPECT LN, BROOMFIELD, CO 80023-4606
(858) 752-8423
Mailing address
1333 CAMINO DEL RIO S STE 103, SAN DIEGO, CA 92108-3520
(619) 501-2195
(619) 501-2176
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 22916
FL
225100000X
Physical Therapist
PT33609
CA
225100000X
Physical Therapist
Primary
PTL0016742
CO
Other
Enumeration date
10/17/2006
Last updated
01/06/2023
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