Individual
EDWARD R WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1200 E BROADWAY, COLUMBIA, MO 65215-1000
(573) 441-5175
Mailing address
1200 E BROADWAY, COLUMBIA, MO 65215-1000
(573) 441-5175
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2005038358
MO
Other
Enumeration date
04/15/2017
Last updated
04/15/2017
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