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Individual

BRIAN WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
361 71ST AVE STE 104, GREELEY, CO 80634-9782
(970) 515-5025
(970) 515-5320
Mailing address
361 71ST AVE STE 104, GREELEY, CO 80634-9782
(970) 515-5320
(970) 515-5320

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
079733108
DUNS
CO
Enumeration date
05/27/2015
Last updated
01/08/2024
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