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General NPI Number Information
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NPI Number | 1043842297
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Entity Type | Individual
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Provider Name | MARINA ADEL WILSON DPT
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Gender | Female
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 3241 S CUSTER RD STE 101
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City | MCKINNEY
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State | TX
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Zip | 75070-1622
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Country | US
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Telephone | 972-979-6577
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Fax | 972-979-6951
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Provider Business Mailing Address
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Address Line | 2001 BUTTERFIELD RD STE 1600
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1211
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Country | US
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Telephone | 866-370-8206
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Fax | 517-435-3670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 045414-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | TX
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