Individual
CARLY M WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1203 CALLAHAN AVE, CONROE, TX 77301-1724
(512) 797-5933
Mailing address
12325 ARIES LOOP S, WILLIS, TX 77318-5228
(512) 797-5933
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1220196
TX
Other
Enumeration date
07/19/2012
Last updated
01/10/2022
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