Individual
MR. GEORGE JAY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
8 CEDAR CT, EAST HAMPTON, NY 11937-2246
(631) 903-7996
Mailing address
8 CEDAR CT, EAST HAMPTON, NY 11937-2246
(631) 903-7996
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
022387-1
NY
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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