Individual
JONATHAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAED, ATC, LAT, CSCS
Contact information
Practice address
1050 UNION UNIVERSITY DR # 1811, JACKSON, TN 38305-3656
(731) 661-5307
Mailing address
1050 UNION UNIVERSITY DR # 1811, JACKSON, TN 38305-3656
(731) 661-5307
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1999
TN
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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