Individual
DR. NOLAN LEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
655 BRANDON TOWN CENTER MALL, BRANDON, FL 33511-4770
(813) 681-1036
Mailing address
5015 BELMONT RD, TAMPA, FL 33647-1319
(813) 787-5995
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5648
FL
Other
Enumeration date
06/23/2019
Last updated
06/23/2019
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