Individual
JONATHAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 E STACY RD, STE 306382, ALLEN, TX 75002-8734
(469) 955-0003
Mailing address
190 E STACY RD, STE 306382, ALLEN, TX 75002-8734
(469) 955-0003
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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