Amy Carole Wilson, PTA

Individual provider Active NPI Physical Therapy Assistant · Dewitt, AR

NPI 1275745010 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1275745010
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA1463 (AR)
Practice address
601 S Union St
Dewitt, AR 72042-2727
Phone
(870) 946-1606
Fax
(870) 946-2937
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA1463ARMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson Therapy Services, Inc. Physical Therapy Assistant Past Accepting new patients
Pattillo Center-School, Incorporated Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA1463 AR Yes

Addresses

Primary practice location

601 S Union St
Dewitt, AR 72042-2727

Mailing address

1310 S Roy St
Dewitt, AR 72042-2992
Phone (870) 946-3497

Other providers in Dewitt, AR

All providers in Dewitt, AR · Physical Therapy Assistant in Arkansas

Sources for this page

Verify at the official NPI Registry.