Individual
MR. ALEX ALLEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5720 3RD AVE, NAMPA, ID 83686-9578
(986) 888-0566
Mailing address
5720 3RD AVE, NAMPA, ID 83686-9578
(986) 888-0566
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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