Individual
BRIAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
6919 NEBO HILLS RD, LIBERTY, MO 64068-8504
(816) 810-8890
Mailing address
6919 NEBO HILLS RD, LIBERTY, MO 64068-8504
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2000175711
MO
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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