Individual
EDLA KALU WILSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12760 S PARK AVE UNIT 520, RIVERTON, UT 84065-3422
(801) 382-8016
Mailing address
2264 N CHURCH ST, LAYTON, UT 84040-7019
(808) 854-3470
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
UT
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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