Individual
CHARLES WILLIAM WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
5815 W. UTOPIA RD., GLENDALE, AZ 85308
(623) 806-7797
Mailing address
98 W LEWIS AVE, PHOENIX, AZ 85003-1071
(602) 570-0162
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-006074
AZ
Other
Enumeration date
01/13/2023
Last updated
01/17/2023
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