Organization
WILSONGROUP, LLC
Active
Other names
WilsonGroup, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLY WILSON JAMES PHD, OTR/L (CEO)
(803) 608-2044
Entity
Organization
Contact information
Practice address
135 GARDEN BROOKE DR, IRMO, SC 29063-7617
(803) 608-2044
Mailing address
135 GARDEN BROOKE DR, IRMO, SC 29063-7617
(803) 608-2044
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1427
SC
Other
Enumeration date
08/07/2008
Last updated
09/18/2015
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