Individual
KEILYN WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
395 VILLAGE DRIVE, KISSIMMEE, FL 34759
(407) 914-9168
(407) 337-8005
Mailing address
2717 EAGLE CANYON DRIVE SOUTH, KISSIMMEE, FL 34746
(919) 606-6423
(407) 337-8005
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA32379
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112243500
—
FL
Enumeration date
10/17/2022
Last updated
10/17/2022
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