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Individual

ANTOINETTE NICHOL WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13575 58TH ST N STE 200, CLEARWATER, FL 33760-3739
(727) 396-1285
Mailing address
13575 58TH ST N STE 200, CLEARWATER, FL 33760-3739
(727) 967-4658

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
03/10/2022
Last updated
03/10/2022
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