Individual
HENRY EUGENE WILSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2301 W BRADLEY AVE STE 2, CHAMPAIGN, IL 61821-1814
(217) 800-5210
Mailing address
2301 W BRADLEY AVE STE 2, CHAMPAIGN, IL 61821-1814
(217) 800-5210
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.016334
IL
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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