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Individual

SCOTT WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
228 WOOD ST, CALIFORNIA, PA 15419-1049
(724) 938-0310
(724) 938-0312
Mailing address
228 WOOD ST, CALIFORNIA, PA 15419-1049
(724) 938-0310
(724) 938-0312

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT015394
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015935850005
PA
Enumeration date
06/30/2006
Last updated
07/09/2007
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