Doctor Name: | JULIANNE MARIE WILSON |
NPI Number: | 1023262151 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 03448 |
Business Practice Address: | 23065 Sw Main St Sherwood, OR - 971406208 |
Business Phone Number: | 5039251802 |
Business Fax Number: | |
Mailing Address: | Po Box 306, SHERWOOD |
State: | OR |
Postal Code: | 971400306 |
Phone Number: | 5039251802 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2008 |
NPI Last Update Date: | 11/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251G0304X |
License Number: | 03448 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Geriatrics |
Taxonomy Definition: |