Individual
MATTHEW WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7700 YORK RD, TOWSON, MD 21204-7513
(410) 821-5500
Mailing address
15115 EASTVIEW DR, UPPERCO, MD 21155-9746
(410) 429-1906
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02387
MD
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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