Individual
BRENDAN R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(419) 979-8111
Mailing address
3901 CLIFTON AVE, CINCINNATI, OH 45220-1145
(419) 979-8111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006484RX
OH
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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