Doctor Name: | KRISTIE MAE WILSON |
NPI Number: | 1376716639 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 5501009262 |
Business Practice Address: | 1428 S Lapeer Rd Lake Orion, MI - 483601437 |
Business Phone Number: | 2486932697 |
Business Fax Number: | 2486933683 |
Mailing Address: | 1428 S Lapeer Rd, LAKE ORION |
State: | MI |
Postal Code: | 483601437 |
Phone Number: | 2486932697 |
Fax Number: | 2486933683 |
NPI Enumeration Date: | 04/08/2008 |
NPI Last Update Date: | 10/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501009262 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |