Individual
KAREN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
8828 W EVENING STAR LN, BOISE, ID 83709-5306
(208) 631-0230
Mailing address
8828 W EVENING STAR LN, BOISE, ID 83709-5306
(208) 631-0230
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3538
ID
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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