Individual
ANGELA KAY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
501 N 3RD ST, PADUCAH, KY 42001-0749
(270) 444-9661
Mailing address
412 S 17TH ST, MAYFIELD, KY 42066-2017
(270) 519-4037
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A01606
KY
Other
Enumeration date
01/21/2013
Last updated
01/21/2013
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