Individual
DR. MICHAEL KENTON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
250 E ELM ST, NASHVILLE, IL 62263-1710
(618) 327-3231
(618) 327-8748
Mailing address
250 E ELM ST, NASHVILLE, IL 62263-1710
(618) 327-3231
(618) 327-8748
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011126
IL
Other
Enumeration date
05/11/2017
Last updated
07/21/2022
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