Individual
GAVIN DAVIS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
915 GARY ST NW, CLEVELAND, TN 37311-4227
(423) 260-0729
Mailing address
1790 RABBIT VALLEY RD NW, CLEVELAND, TN 37312-6921
(423) 260-0729
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
3035
TN
Other
Enumeration date
01/30/2024
Last updated
05/04/2026
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