MEDICARE: D'ASYA WILSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1003747122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	D'ASYA WILSON

Provider Business Mailing Address
First Line	:	209 HALIFAX ST
Second Line	:
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892-1816
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 HALIFAX ST
Second Line	:
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892-1816
Country	:	US
Telephone Number	:	252-217-7159
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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Directions to “ D'ASYA WILSON ” Practice Location

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