Kenneth Monroe Wilson, MHO PT SCS ATC

NPI #1396854915 in Farmington, Missouri

Provider Information

NPI Number: 1396854915
Entity Type: Individual
Name: Kenneth Monroe Wilson, MHO PT SCS ATC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MHO PT SCS ATC
Enumeration Date: Aug 29, 2006
Last Updated: Jan 22, 2008

Practice Location

Address: 1355 MAPLE STREET
City: Farmington
State: Missouri
ZIP Code: 63640
Phone: (573) 756-9900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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