Individual
TREY ALLEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
1123 W 2ND ST, ANDERSON, IN 46016-2315
(765) 774-2259
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002760A
IN
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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