Individual
BRENT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD/LD
Contact information
Practice address
3300 NW EXPRESSWAY, OKLAHOMA CITY, OK 73112-4418
(405) 949-6000
(405) 949-6093
Mailing address
3300 NW EXPRESSWAY, OKLAHOMA CITY, OK 73112-4418
(405) 949-6000
(405) 949-6093
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2013
OK
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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