Individual
ASANI WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1701 NW HAWTHORNE AV, #103, GRANTS PASS, OR 97526
(541) 592-6580
(541) 592-5489
Mailing address
1701 NW HAWTHORNE AV, # 103, GRANTS PASS, OR 97526
(541) 476-2502
(541) 476-2397
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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