Annetta Wilson, P.T

NPI 1891025482 · on the registry since 2010 · sole proprietor

Practice

Address: 640 N Eisenhower St
Moscow, ID 83843
Phone: (208) 882-6560
Fax: (208) 882-6569
Organisation at this address: Moscow Of Olympus Llc
Moscow North Of Cascadia, Llc
The Evangelical Lutheran Good Samaritan Society
The Evangelical Lutheran Good Samaritan Society
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 8

Registry record

Primary taxonomy: 174400000X
174400000X
Also registered as: 174400000X
Licence states on file: WA, ID
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2010-01-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho