Individual
JOHNATHAN WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3832 DEL RIO DR, FORT WORTH, TX 76133-7106
(682) 433-1590
Mailing address
3832 DEL RIO DR, FORT WORTH, TX 76133-7106
(682) 433-1590
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/07/2019
Last updated
04/07/2019
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