Individual
MR. STANLEY KEITH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1510 W 4TH ST, COFFEYVILLE, KS 67337-3332
(620) 251-1024
(620) 251-6373
Mailing address
1510 W 4TH ST, PO BOX 362, COFFEYVILLE, KS 67337-3332
(620) 251-1024
(620) 251-6373
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
858
KS
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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