Individual
JOSHUA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3301 NW 50TH ST, OKLAHOMA CITY, OK 73112-5627
(405) 947-0911
Mailing address
3301 NW 50TH ST, OKLAHOMA CITY, OK 73112-5627
(405) 947-0911
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
498
OK
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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