Individual
MR. BRUCE DOUGLAS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7617 E 82ND PL N, OWASSO, OK 74055-9010
(405) 410-5517
Mailing address
7617 E 82ND PL N, OWASSO, OK 74055-9010
(405) 410-5517
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/30/2026
Last updated
01/30/2026
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