| NPI | 1750715157 |
|---|---|
| Former Name | ASHLEY MICHELLE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-05710) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-4232) |
| 225100000X Physical Therapist (Licence: MO 2013028760) | |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2018-12-10 |