Individual
KENNETH R WILSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2081 CHAFFEE RD S LOT 119, JACKSONVILLE, FL 32221-1887
(904) 834-9093
Mailing address
2081 CHAFFEE RD S LOT 119, JACKSONVILLE, FL 32221-1887
(904) 834-9093
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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