Most Relevant Information
Provider Data
| NPI Number: | 1003405069 |
| Provider Name: | DANIELLE WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 225400000X |
| Specialty: | Rehabilitation Practitioner |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/14/2021 |
| Last Updated: | 01/14/2021 |
Provider Practice Location
10447 GOLD SHADOW AVE
LAS VEGAS
NV
891293316
Practice Location Phone/Fax
| Phone: | 7023855331 |
| Fax: |
Provider Mailing Location
4285 N RANCHO DR STE 130
LAS VEGAS
NV
891303455
Provider Mailing Phone/Fax
| Phone: | 7023855331 |
| Fax: |