Individual
JYKEDRIN DANTREL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 BRYSON AVE, MOUNT PLEASANT, TN 38474-1308
(313) 878-5288
Mailing address
303 BRYSON AVE, MOUNT PLEASANT, TN 38474-1308
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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