Individual
DUSTIN RAY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS ATC CSCS
Contact information
Practice address
WESTERN KENTUCKY UNIVESITY ATHLETIC TRAINING, 1605 AVENUE OF CHAMPIONS, BOWLING GREEN, KY 42101-6412
(270) 745-6029
(270) 745-5333
Mailing address
130 OLD SCOTTSVILLE LOOP 1 RD, GLASGOW, KY 42141-8750
(270) 745-6029
(270) 745-5333
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT525
KY
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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