Individual
MR. WILSON JEFFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
ADDRESS: 235 NEW WILSON LANE, MIDDLESBORO, KY 40965
(606) 248-0925
Mailing address
658 PAULA DRIVE, PINEVILLE, KY 40977
(606) 306-5174
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
172346
KY
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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