Provider Demographics
NPI:1093230914
Name:WILSON, NORA A (DPT)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:A
Last Name:WILSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1046
Mailing Address - Country:US
Mailing Address - Phone:413-529-9300
Mailing Address - Fax:866-644-0870
Practice Address - Street 1:238 NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1046
Practice Address - Country:US
Practice Address - Phone:413-529-9300
Practice Address - Fax:866-644-0870
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23251225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist