Individual
SCOTT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
751 STOKES RD, MEDFORD, NJ 08055-3002
(609) 654-7496
(609) 953-9346
Mailing address
1769 REDWOOD DR, VINELAND, NJ 08361-6769
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
484
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3470601
—
NJ
Enumeration date
03/23/2007
Last updated
07/09/2007
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