Individual
ANTHONY BRADFORD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7219 N LITCHFIELD RD, GLENDALE, AZ 85309-1529
(623) 856-2793
Mailing address
16654 N 178TH AVE, SURPRISE, AZ 85388-1798
(623) 221-1089
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
03/09/2011
Last updated
03/09/2011
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