# MR. BRIAN S WILSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1821238932
- **Gender:** Man
- **Credential:** D.P.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 5887 | OR | Yes |

## Other

- **Enumeration date:** 03/02/2009
- **Last updated:** 12/03/2010