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1174055750
MARCUS JAY WILSON
THORNTON, CO
NPI
1174055750
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO NLC.0106799)
Enumeration Date
2017-04-01
Last Update Date
2017-04-01
Business Address
-- MARCUS JAY WILSON BA
8931 HURON ST
THORNTON, CO 80260-6806
Phone number: 303-853-3500
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Mailing Address
-- MARCUS JAY WILSON BA
8931 HURON ST
THORNTON, CO 80260-6806
Phone number: 303-853-3500
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