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General NPI Number Information
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NPI Number | 1538552526
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Entity Type | Individual
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Provider Name | JENNIFER LOUISE WILSON MS, ATC,
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Gender | Female
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Dates
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Enumeration Date | 03/15/2015
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Last Update Date | 03/15/2015
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Provider Practice Location Address
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Address Line | 119 SEABOARD LN STE. 401
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City | FRANKLIN
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State | TN
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Zip | 37067-8306
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Country | US
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Telephone | 615-915-4181
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Fax |
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Provider Business Mailing Address
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Address Line | 200 KEDRON PKWY 280N
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City | SPRING HILL
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State | TN
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Zip | 37174-2462
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Country | US
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Telephone | 931-217-1749
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1331
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License Number State | TN
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