Individual
DAVID M. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
7510 MADISON ST, MERRILLVILLE, IN 46410-4609
(219) 795-0765
Mailing address
7510 MADISON ST, MERRILLVILLE, IN 46410-4609
(219) 781-0765
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000725A
IN
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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