Individual
STORMY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15500 555TH ST, LUCAS, IA 50151-8473
(641) 342-5340
Mailing address
800 S FILLMORE ST, OSCEOLA, IA 50213-1619
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004751
IA
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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