Individual
CARRIE ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
820 VILLAGE SQ, GRETNA, NE 68028-7914
(402) 932-0747
(402) 991-5685
Mailing address
820 VILLAGE SQ, GRETNA, NE 68028-7914
(402) 932-0747
(402) 991-5685
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1536
SD
225100000X
Physical Therapist
Primary
2962
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47065477701
—
NE
Enumeration date
01/19/2011
Last updated
03/17/2018
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