KELLY DIANE WILSON

COSTA MESA, CA
NPI1801349162
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2016-08-03
Last Update Date2016-08-03
Business Address
-- KELLY DIANE WILSON MS, ATC
55 FAIR DR
COSTA MESA, CA 92626-6520
Phone number: 714-619-6618
Mailing Address
-- KELLY DIANE WILSON MS, ATC
602 CENTER ST APT C-1
COSTA MESA, CA 92627-2781
Phone number: 562-293-5600
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