Individual
CHARLES LOUIS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2900 GOVERNMENT ST STE A, OCEAN SPRINGS, MS 39564-5647
(228) 861-5832
Mailing address
2900 GOVERNMENT ST STE A, OCEAN SPRINGS, MS 39564-5647
(228) 861-5832
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
533
MS
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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