Individual
JUDD WEST WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1702 OWEN DR, FAYETTEVILLE, NC 28304-3419
(910) 323-3184
Mailing address
2313 OLD HENSON COVE RD, CANTON, NC 28716-6872
(828) 593-9660
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P12366
NC
Other
Enumeration date
05/02/2012
Last updated
05/02/2012
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