NPI 1821295049

Diane Alice Wilson, RPT

Practitioner Mechanotherapist Stanberry, MO

Practice location

Address: 307 N Pineview St, Stanberry, MO 64489-1509
Phone: (660) 783-2118

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence MO00988 (MO)

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Registry record

NPI: 1821295049
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Jun 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.