Individual
LENNARD STEVEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2835 FORT MISSOULA RD, STE 203, MISSOULA, MT 59804-7423
(406) 327-4091
(406) 327-4590
Mailing address
6520 DRIFTWOOD LN, MISSOULA, MT 59803-3218
(406) 251-5253
(406) 251-6153
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
6749
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0088049
—
MT
Enumeration date
09/16/2005
Last updated
04/29/2021
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