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Individual

TARA SANSONE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
11539 PARK WOODS CIR, SUITE 502, ALPHARETTA, GA 30005-4413
(678) 527-3224
(678) 366-5886
Mailing address
3575 OLD ALABAMA RD, ALPHARETTA, GA 30022-6319
(561) 234-0431

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT009614
GA
225100000X
Physical Therapist
PT 24102
FL

Other

Enumeration date
06/27/2008
Last updated
06/09/2009
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