Individual
MR. THOMAS ALVIN WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
300 W MAIN ST, MEDFORD, OR 97501-2756
(541) 772-1777
Mailing address
300 W MAIN ST, MEDFORD, OR 97501-2756
(541) 772-1777
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
24-CRM-3633
OR
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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