Individual
MR. DAVID WILSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
2904 ODONNELL ST, BALTIMORE, MD 21224-4820
(443) 710-5509
Mailing address
2904 ODONNELL ST, BALTIMORE, MD 21224-4820
(443) 710-5509
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M05298
MD
Other
Enumeration date
05/01/2015
Last updated
05/01/2015
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