Individual
WILLIM WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2415 MCCALLIE AVE, CHATTANOOGA, TN 37404-3322
(423) 624-2696
Mailing address
2415 MCCALLIE AVE, CHATTANOOGA, TN 37404-3322
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1477
TN
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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