Barbara Booth Wilson, ATC, LIC

NPI #1215133863 in Saint Leo, Florida

Provider Information

NPI Number: 1215133863
Entity Type: Individual
Name: Barbara Booth Wilson, ATC, LIC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: ATC, LIC
Enumeration Date: Jun 21, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: UNIVERSITY CAMPUS MC 2038 SAINT LEO UNIVERSITY
Address 2: 33701 ST RD 52
City: Saint Leo
State: Florida
ZIP Code: 33574
Phone: (352) 588-8222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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