Individual
BRETT LANIER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2325 NW 46TH ST, LINCOLN, NE 68524-6019
(402) 202-2314
Mailing address
2325 NW 46TH ST, LINCOLN, NE 68524-6019
(402) 202-2314
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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