Individual
DR. JADE WILCOXSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
213 N 2ND ST, TALENT, OR 97540-9753
(541) 326-5454
Mailing address
PO BOX 1098, TALENT, OR 97540-1098
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04814
OR
Other
Enumeration date
08/07/2016
Last updated
08/07/2016
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