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General NPI Number Information
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NPI Number | 1427903533
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Entity Type | Individual
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Provider Name | RILEY WILSON
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Gender | Female
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 1901 N HEMMER RD APT 109
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City | PALMER
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State | AK
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Zip | 99645-9673
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Country | US
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Telephone | 907-795-8115
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Fax |
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Provider Business Mailing Address
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Address Line | 19839 TULWAR DR
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City | CHUGIAK
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State | AK
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Zip | 99567-6353
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Country | US
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Telephone |
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 248400
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License Number State | AK
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