Individual
MR. TERRY LEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1050 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-6161
Mailing address
1050 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-6161
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2175033
WI
Other
Enumeration date
01/08/2007
Last updated
08/07/2023
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