Individual
CLAY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
1695 LEE ROAD, C201, WINTER PARK, FL 32789
(904) 591-9038
Mailing address
1695 LEE ROAD, C201, WINTER PARK, FL 32789
(904) 591-9038
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA39687
FL
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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