Individual
CASEY V WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
999 W PLYMOUTH AVE, DELAND, FL 32720-3134
(386) 740-7080
(386) 734-0821
Mailing address
999 W PLYMOUTH AVE, DELAND, FL 32720-3134
(386) 740-7080
(386) 734-0821
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103729
FL
Other
Enumeration date
08/18/2006
Last updated
04/06/2019
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