Individual
KIMBERLYN JENA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
260 W CLINTON ST STE 2, GRAY, GA 31032-5464
(478) 936-7621
(888) 369-9044
Mailing address
162 SHOAL CREEK RD, ROUND OAK, GA 31038-3001
(478) 550-3702
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013404
GA
Other
Enumeration date
07/31/2019
Last updated
12/26/2022
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