Individual
MR. NELSON WILSON IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
801 E NORTHSIDE DR, SUITE D, CLINTON, MS 39056-3663
(601) 924-2888
(601) 924-2885
Mailing address
801 E NORTHSIDE DR, SUITE D, CLINTON, MS 39056-3663
(601) 924-2888
(601) 924-2885
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
C36423
MS
Other
Enumeration date
06/10/2008
Last updated
06/10/2008
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