Individual
SAMUEL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
609 S 5TH ST, WORLAND, WY 82401-3809
(406) 647-9633
Mailing address
609 S 5TH ST, WORLAND, WY 82401-3809
(406) 647-9633
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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