Individual
CHASITY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
850 E SKAGGS CT, GREENSBURG, IN 47240-9422
(812) 560-9915
Mailing address
850 E SKAGGS CT, GREENSBURG, IN 47240-9422
(812) 560-9915
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002269A
IN
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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