KEN WILSON

AUGUSTA, GA
NPI1104223999
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: GA  564)
Enumeration Date2014-11-24
Last Update Date2014-11-24
Business Address
MR. KEN WILSON
2610 COMMONS BLVD
AUGUSTA, GA 30909-2080
Phone number: 706-733-1935
Mailing Address
MR. KEN WILSON
2610 COMMONS BLVD
AUGUSTA, GA 30909-2080
Phone number: 706-733-1935
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