Organization
OUTREACH HEALTH INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHESTER LEE WILSON JR. ED.D. (CHIEF EXECUTIVE OFFICER)
(386) 675-0098
Entity
Organization
Contact information
Practice address
240 N FREDERICK AVE, DAYTONA BEACH, FL 32114-3400
(386) 255-5569
(386) 257-1245
Mailing address
240 N FREDERICK AVE, DAYTONA BEACH, FL 32114-3400
(386) 255-5569
(386) 257-1245
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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