Individual
CHANDI R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3065 COLLEGE RD, FAIRBANKS, AK 99709-3702
(907) 374-1686
Mailing address
906 ROTHBURY CIR, ELIZABETHTOWN, KY 42701-6498
(270) 505-6068
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
208217
AK
Other
Enumeration date
04/20/2023
Last updated
04/20/2023
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