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NPI Code Detail

MEDICARE: CLAIRE WILSON

MEDICARE: CLAIRE 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
1225200000XPhysical Therapy AssistantCO
2225200000XPhysical Therapy AssistantPTA.0014752CO

General Provider Information

NPI Number : 1073198750
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAIRE WILSON
Provider Business Mailing Address
First Line : 1333 W 116TH AVE APT 304
Second Line :
City : WESTMINSTER
State : CO
Zip : 80234-3522
Country : US
Telephone Number : 812-604-8400
Fax Number :
Provider Business Practice Location Address
First Line : 4800 TABOR ST
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-2112
Country : US
Telephone Number : 303-421-4161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2021
Last Update Date : 03/18/2021

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Directions to “ CLAIRE WILSON ” Practice Location

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