Individual
CHANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2202 STRATTON LN APT 16206, ARLINGTON, TX 76006-5453
(678) 979-9171
Mailing address
2202 STRATTON LN APT 16206, ARLINGTON, TX 76006-5453
(678) 979-9171
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
326695
TX
Other
Enumeration date
02/18/2018
Last updated
02/18/2018
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