Individual
JEFFERY MORGAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2217 DILLON RD, CLOVIS, NM 88101-9454
(575) 769-7356
Mailing address
2272 TAOS CT, PORTALES, NM 88130-9386
(239) 791-9308
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
4368
NM
Other
Enumeration date
08/23/2013
Last updated
08/23/2013
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