Individual
JONATHAN B WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
802 EAST MAIN ST, MANNINGTON, WV 26582
(304) 986-9007
(304) 986-9007
Mailing address
719 FAIRMONT AVENUE, SUITE 102, FAIRMONT, WV 26554
(304) 363-8543
(304) 363-0173
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002873
WV
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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