IndividualActive
Kylan Wilson, CERTIFIED PEDORTHIST
NPI 1174934186 · Orthotist · San Angelo, TX
Provider details
- NPI number
- 1174934186
- Entity type
- Individual
- Primary specialty
- OrthotistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CERTIFIED PEDORTHIST
- Sex
- Male
- Sole proprietor
- No
- License
- 4075 (TX)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
110 E Twohig Ave
San Angelo, TX 76903-5916
Phone: (325) 658-1511
Fax: (325) 481-2166
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 22000
San Angelo, TX 76902-7200
Registry dates
- Enumerated
- 2014-05-13
- Last updated
- 2014-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.