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Individual

ERIK WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
GENERAL MANAGER

Contact information

Practice address
29240 BUCKINGHAM ST, 11, LIVONIA, MI 48154-4575
(734) 513-2800
(734) 513-3606
Mailing address
29240 BUCKINGHAM, 11, LIVONIA, MI 48154
(734) 513-2800
(734) 513-3606

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MI-10191M
MI

Other

Enumeration date
02/07/2014
Last updated
02/07/2014
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