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Individual

MR. KYLE STEVEN WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.ED., ATC, LAT

Contact information

Practice address
4505 S MARYLAND PKWY, BOX 450007, LAS VEGAS, NV 89154-9900
(702) 895-4037
Mailing address
8161 TONE ST, LAS VEGAS, NV 89123-0214
(702) 895-4037
(702) 895-4474

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506002
NV

Other

Enumeration date
04/16/2007
Last updated
07/08/2007
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