Mallori Jo Wilson

NPI #1740455732 in Herrin, Illinois

Provider Information

NPI Number
1740455732
Entity Type
Individual
Name
Mallori Jo Wilson
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physical Therapist
Enumeration Date
Apr 29, 2008
Last Updated
Jan 25, 2011

Practice Location

Address
14341 ALLEN RD
City
Herrin
ZIP Code
62948-6446
Phone
(618) 559-6377

Specialties & Taxonomy Codes

Specialty
Physical Therapist

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