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1649215450
MITSUE ALICE WILCOXSON
WEST LAFAYETTE, IN
NPI
1649215450
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Primary Taxonomy
225100000X Physical Therapist
Additional Taxonomies
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2006-06-17
Last Update Date
2007-07-08
Business Address
MRS. MITSUE ALICE WILCOXSON ATC, PT
900 N UNIVERSITY ST B63 MACKEY ARENA, PURDUE UNIVERSITY
WEST LAFAYETTE, IN 47907-2070
Phone number: 765-494-1703
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Mailing Address
MRS. MITSUE ALICE WILCOXSON ATC, PT
1709 SUMMIT DR
WEST LAFAYETTE, IN 47906-2229
Phone number: 765-497-0849
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