Wilson, Jacqui R

Wilson, Jacqui R is an individual health care provider with primary practice located at 1912 Memorial Ave , Lynchburg VA 24501-1708. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Wilson, Jacqui R can be contacted via phone (434) 845-8765.

Contact Information

Primary practice address
1912 Memorial Ave Lynchburg VA 24501-1708
Phone: (434) 845-8765
Fax: (434) 845-8467
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 2306001329 Virginia

Profile Details

NPI number 1023261666
LBN Legal business name Wilson, Jacqui R
Credentials LPTA
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2008
Last updated Oct 28th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023261666 NPPES
Virginia MEDICAID 004978757
Virginia Other 192595
Virginia Other 496612

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