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1134862337
IAN THOMAS WILSON
GRAND JUNCTION, CO
NPI
1134862337
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA 9502163)
Enumeration Date
2022-04-15
Last Update Date
2022-04-15
Business Address
IAN THOMAS WILSON
2121 NORTH AVE
GRAND JUNCTION, CO 81501-6428
Phone number: 970-242-0731
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Mailing Address
IAN THOMAS WILSON
3231 LAKESIDE DR APT 203
GRAND JUNCTION, CO 81506-2846
Phone number: 951-743-9989
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