Individual
TONYA LAVETTE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1261 ABBEY PINES DR, PERRIS, CA 92571-9409
(951) 201-9411
Mailing address
2300 W SAHARA AVE STE 800, LAS VEGAS, NV 89102-4397
(951) 201-9411
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
CA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NV
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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