Individual
KEVIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
325 PIEDMONT DR STE 2005, DANVILLE, VA 24540-4175
(434) 710-4210
Mailing address
325 PIEDMONT DR STE 2005, DANVILLE, VA 24540-4175
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L006913
NC
Other
Enumeration date
04/11/2025
Last updated
04/11/2025
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