Individual
JAMES THOMAS WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
696 MAGNOLIA AVE, BREA, CA 92821-6552
(714) 612-2831
Mailing address
696 MAGNOLIA AVE, BREA, CA 92821-6552
(714) 612-2831
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/26/2006
Last updated
07/08/2007
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