Individual
COREY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 HILL AVE STE 101, NASHVILLE, TN 37210-4755
(615) 329-4790
Mailing address
550 HARBOR COVE LN APT 2300J, CHARLESTON, SC 29412-3031
(803) 427-7602
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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