Individual
SCOTT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7512 W LEMHI ST STE 2, BOISE, ID 83709-2877
(801) 430-8550
Mailing address
430 N STATION PKWY APT 554, FARMINGTON, UT 84025-3151
(801) 430-8550
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
ID
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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