Individual
TODD WILSON GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.P.T.
Contact information
Practice address
3030 PINE ST, ARKADELPHIA, AR 71923-5325
(870) 246-8623
(870) 246-8694
Mailing address
3030 PINE ST, ARKADELPHIA, AR 71923-5325
(870) 246-8623
(870) 246-8694
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 909
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141081721
—
AR
01
—
56477
ARKANSAS BCBS
AR
Enumeration date
11/09/2005
Last updated
05/15/2009
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