Individual
JENNIFER ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2555 JIMMY JOHNSON BLVD, PORT ARTHUR, TX 77640-2007
(409) 548-1327
Mailing address
9306 LISA LN, PORT ARTHUR, TX 77640-6909
(409) 548-1327
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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