Individual
MR. RONNELL M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5175 CAMINO AL NORTE, SUIT 100, NORTH LAS VEGAS, NV 89031-2407
(702) 648-3913
Mailing address
5400 W CHEYENNE AVE, APT 1106, LAS VEGAS, NV 89108-4724
(951) 250-1868
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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