Individual
MR. WILSON FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1008 S SPRING AVE, SAINT LOUIS, MO 63110-2520
(314) 617-3955
Mailing address
1008 S SPRING AVE, SAINT LOUIS, MO 63110-2520
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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