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Individual

WILSON BRUCE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CF/SLP

Contact information

Practice address
18740 COUNTY ROAD V, LEWIS, CO 81327-9610
(970) 882-3186
Mailing address
18740 COUNTY ROAD V, LEWIS, CO 81327-9610
(970) 882-3186

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PENDING
NM

Other

Enumeration date
12/12/2008
Last updated
12/12/2008
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