Organization
TH WILSON NEUROMONITORING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
G ANDREW WILSON MD (SOLE MEMBER)
(800) 310-7334
Entity
Organization
Contact information
Practice address
3536 HELEN AVENUE DR, TERRE HAUTE, IN 47802-3426
(800) 310-7334
Mailing address
DEPT 880285 PO BOX 29654, PHOENIX, AZ 85038-9650
(800) 310-7334
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
—
—
Other
Enumeration date
09/12/2018
Last updated
04/10/2019
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