| Organization Name: | WILSON ORTHOPEDIC AND SPORTS PT |
| NPI Number: | 1003088667 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NICHOLAS D WILSON (PT/OWNER) |
| Mailing Address: | 476 Fortman Dr Saint Marys |
| State: | OH US |
| Postal Code: | 458851870 |
| Phone Number: | 4193008400 |
| Fax Number: | 4193008401 |
| NPI Enumeration Date: | 03/24/2008 |
| NPI Last Update Date: | 03/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |