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Individual

JOHN R WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BOCPO

Contact information

Practice address
1904 SE WASHINGTON BLVD, BARTLESVILLE, OK 74006-6736
(918) 333-6900
(918) 335-6687
Mailing address
1904 SE WASHINGTON BLVD, BARTLESVILLE, OK 74006-6736
(918) 333-6900
(918) 335-6687

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
LPO40
OK
224P00000X
Prosthetist
Primary
LPO40
OK

Other

Enumeration date
01/16/2009
Last updated
01/16/2009
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