Individual
MR. WILSON G BRYANT III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19196 PINE WAY, APPLE VALLEY, CA 92308-4914
(760) 490-7367
Mailing address
19196 PINE WAY, APPLE VALLEY, CA 92308-4914
(760) 490-7367
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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