Individual
EDWARD ALEXANDER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
6365 W OKMULGEE ST, MUSKOGEE, OK 74401-4595
(918) 687-1039
(918) 683-9484
Mailing address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 682-8407
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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