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Individual

MRS. MELINDA DILLARD WILSON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
2631 TEMPLE AVE N, FAYETTE, AL 35555-1157
(800) 648-3271
(205) 932-2153
Mailing address
128 ALLYN TRCE, WINFIELD, AL 35594-6261
(205) 487-7080

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
037
AL

Other

Enumeration date
02/13/2006
Last updated
07/08/2007
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