Individual
THERESA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 HUMPHREYS CENTER DR, MEMPHIS, TN 38120-2353
(901) 226-4280
Mailing address
7123 MUNFORD GILTEDGE RD, BURLISON, TN 38015-7305
(662) 216-9856
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
204945
TN
Other
Enumeration date
07/11/2025
Last updated
07/11/2025
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