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Individual

JUSTINE BREANNE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
11811 N TATUM BLVD STE 3031, PHOENIX, AZ 85028-1621
(602) 708-8091
(602) 218-6462
Mailing address
11811 N TATUM BLVD STE 3031, PHOENIX, AZ 85028-1621
(602) 708-8091
(602) 218-6462

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60957709
WA

Other

Enumeration date
12/02/2019
Last updated
08/02/2023
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