Kelly Diane Wilson, MS, ATC is a student in an organized health care education training program in Costa Mesa, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Kelly Diane Wilson, MS, ATC NPI is 1801349162. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
55 FAIR DR
COSTA MESA, CA
ZIP 92626-520
Phone: (714) 619-6618
The enumeration date for this NPI number is 8/3/2016 and was last updated on 8/3/2016.