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Individual

LARRY WAYNE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4240 BLUE RIDGE BLVD, #510, KANSAS CITY, MO 64133-1713
(913) 766-4888
(913) 766-4889
Mailing address
2040 HUTTON RD, #108, KANSAS CITY, KS 66109
(913) 766-4888
(913) 766-4889

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
001255
MO
237700000X
Hearing Instrument Specialist
1480
KS

Other

Enumeration date
11/17/2006
Last updated
04/07/2017
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