Individual
MRS. JOHANNA A WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
60 BRIMLEY DR, FREDERICKSBURG, VA 22406-5148
(540) 369-6458
Mailing address
1402 FORBES ST, FREDERICKSBURG, VA 22405-1419
(703) 973-1583
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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