Individual
JONAH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
300 W OTTLEY AVE, FRUITA, CO 81521-2118
(970) 858-2705
(970) 858-9961
Mailing address
PO BOX 130, FRUITA, CO 81521-0130
(970) 260-7454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0009248
CO
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/01/2023
Last updated
08/05/2025
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