Healthcare Provider Details

I. General information

NPI: 1992897540
Provider Name (Legal Business Name): ERIN H WILSON P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

384 COURTLAND LN
PICKERINGTON OH
43147-1523
US

IV. Provider business mailing address

11177 LAMBS LN
NEWARK OH
43055-9779
US

V. Phone/Fax

Practice location:
  • Phone: 614-837-8227
  • Fax: 614-837-9796
Mailing address:
  • Phone: 740-763-0408
  • Fax: 740-763-0475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9729
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: