Individual
DANIEL CHRISTOPHER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2902 BRADFORD ST NE, GRAND RAPIDS, MI 49525-6427
(616) 885-5200
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704288021
MI
Other
Enumeration date
09/20/2021
Last updated
11/22/2021
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