Individual
MR. BRIAN M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
33 ROGER ST, LEWISTON, ME 04240-3328
(207) 784-0108
Mailing address
18 MOREAU AVE, LEWISTON, ME 04240-4032
(207) 784-8091
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1031
ME
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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