LEVI WILLIAM WILSON

BROOKHAVEN, GA
NPI1164049136
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA  AT002885)
Enumeration Date2020-06-25
Last Update Date2020-06-25
Business Address
LEVI WILLIAM WILSON ATC
1575 N EAST EXPY NE
BROOKHAVEN, GA 30329-2401
Phone number: 543-740-4758
Mailing Address
LEVI WILLIAM WILSON ATC
390 APPLE RIDGE 2
DAWSONVILLE, GA 30534-5140
Phone number: