KENNETH WADE WILSON

RIDGELAND, MS
NPI1205980141
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: MS  TA1911)
Enumeration Date2007-01-22
Last Update Date2007-07-08
Business Address
Mr. KENNETH WADE WILSON COTA-L
711 AVIGNON DR
RIDGELAND, MS 39157-5120
Phone number: 601-605-6777
Mailing Address
Mr. KENNETH WADE WILSON COTA-L
37 NORTHWOOD DR
PETAL, MS 39465-9537
Phone number: 601-584-6725
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