Individual
HOLLY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
360 HUNTINGTON AVE, BOSTON, MA 02115-5005
(617) 373-3195
Mailing address
448 PARK DR APT 6, BOSTON, MA 02215-3722
(301) 602-1070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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