Individual
SHAWNA SUE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
502 N 9TH AVE, VINTON, IA 52349-2254
(319) 472-6220
Mailing address
2409 DEBORAH DR SW, CEDAR RAPIDS, IA 52404-3714
(319) 470-3751
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
092206
IA
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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