Individual
ADAM WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1505 11TH ST, SANTA MONICA, CA 90401-2903
(424) 322-8585
Mailing address
612 E NEWMARK AVE APT B, MONTEREY PARK, CA 91755-3178
(206) 484-5145
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
302753
CA
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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