Individual
MR. SCOTT CULLEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
36 WILKINSON RD, RANDOLPH, NJ 07869-3470
(973) 722-6822
Mailing address
36 WILKINSON RD, RANDOLPH, NJ 07869-3470
(973) 722-6822
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00285100
NJ
Other
Enumeration date
06/10/2010
Last updated
06/10/2010
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