Individual
RICHARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 UNION ST, LAWRENCE, MA 01840-1866
(978) 688-4830
(978) 688-4901
Mailing address
84 MAIN ST., PO BOX 179, NEWFIELDS, NH 03856-0179
(603) 498-9154
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/24/2010
Last updated
06/11/2013
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