Individual
JEREMY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
WRAPAROUND
Contact information
Practice address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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