Individual
DIANA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6551 GRAND RIVER AVE, DETROIT, MI 48208-1125
(313) 656-4494
(313) 656-4494
Mailing address
6551 GRAND RIVER AVE, DETROIT, MI 48208-1125
(313) 656-4494
(313) 656-4494
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
MDOT-71649
MI
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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