Individual
MR. CRAIG ROBERT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
1003 N BORADWAY, JOHNSON CITY, TN 37601
(423) 232-4326
(423) 232-4255
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3696
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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