Individual
LEVAR ANTONE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MEDICAL SUPPLY
Contact information
Practice address
4134 SW 51ST TER, OCALA, FL 34474-9699
(352) 207-3144
Mailing address
4134 SW 51ST TER, OCALA, FL 34474-9699
(352) 207-3144
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
FL
Other
Enumeration date
04/27/2021
Last updated
04/27/2021
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