Individual
JEFFREY F WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD PC
Contact information
Practice address
126 W WHEATLAND AVE, REMUS, MI 49340
(989) 967-8668
(989) 967-3032
Mailing address
126 W WHEATLAND AVE, P O BOX 321, REMUS, MI 49340-0321
(989) 967-8668
(989) 967-3032
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003093
MI
152WC0802X
Corneal and Contact Management Optometrist
4901003093
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4373941
—
MI
Enumeration date
09/07/2006
Last updated
01/06/2011
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