RAYMOND JAMES WILSON

FORT WAYNE, IN
NPI1154783082
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36002467A)
Enumeration Date2016-03-21
Last Update Date2016-03-21
Business Address
-- RAYMOND JAMES WILSON ATC, LAT
11130 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845-1735
Phone number: 765-860-5307
Mailing Address
-- RAYMOND JAMES WILSON ATC, LAT
11130 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845-1735
Phone number: 765-860-5307
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