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Individual

MR. JOHN JAY WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.O.T.A./L.

Contact information

Practice address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-7786
Mailing address
2650 SUNSET DR, GLENN HEIGHTS, TX 75154-2022
(214) 808-3545

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208194
TX

Other

Enumeration date
07/26/2012
Last updated
07/26/2012
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