Individual
PRESTON JON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8846 S REDWOOD RD STE E121, WEST JORDAN, UT 84088-9366
(801) 569-1999
(801) 569-2001
Mailing address
PO BOX 198560, ATLANTA, GA 30384-8560
(801) 576-8855
(801) 576-9800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125-056771
IL
Other
Enumeration date
06/19/2009
Last updated
11/30/2020
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