Individual
DR. ROBERT L WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
617 MARKET STREET, PROSSER, WA 99350-1341
(509) 786-3111
(509) 786-3188
Mailing address
617 MARKET ST, PROSSER, WA 99350-1341
(509) 786-3111
(509) 786-3188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001687
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020584
—
WA
Enumeration date
10/20/2006
Last updated
10/16/2009
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