Individual
JULIE P. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
725 AMERICAN AVE, WAUKESHA, WI 53188-5031
(262) 928-8200
(262) 928-8699
Mailing address
N17W24100 RIVERWOOD DR, SUITE 250, WAUKESHA, WI 53188-1177
(262) 928-4100
(262) 928-5835
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
39064
WI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
39064
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31389100
—
WI
Enumeration date
02/13/2006
Last updated
10/26/2011
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