Individual
NICHOLAS ROBERT-VINCENT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
513 W 12TH ST APT J, NEWTON, KS 67114-1792
(989) 590-2082
Mailing address
513 W 12TH ST APT J, NEWTON, KS 67114-1792
(989) 590-2082
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MI
Other
Enumeration date
07/01/2016
Last updated
08/10/2016
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