Individual
DR. THADDEUS EARL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11406 LOMA LINDA DR, PHYSICAL MEDICINE AND REHABILITATION, LOMA LINDA, CA 92354-3711
(909) 558-6275
(909) 558-6212
Mailing address
11406 LOMA LINDA DRIVE, PHYSICAL MEDICINE AND REHABILITATION, LOMA LINDA, CA 92354
(909) 558-6275
(909) 558-6212
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
A102261
CA
Other
Enumeration date
05/14/2007
Last updated
08/15/2014
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