Individual
MISS ANNE JEANNETTE WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
3832 E MAIN ST, UNIT E & F, FARMINGTON, NM 87402
(505) 564-2955
(505) 564-2662
Mailing address
3832 E MAIN ST, UNIT E & F, FARMINGTON, NM 87402
(505) 564-2955
(505) 564-2662
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A0457
NM
Other
Enumeration date
04/05/2006
Last updated
07/08/2007
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