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1417420704
JUSTIN WILSON
CULLMAN, AL
NPI
1417420704
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AL 1-133787)
Enumeration Date
2019-01-09
Last Update Date
2024-03-15
Business Address
JUSTIN WILSON CRNP
408 CLARK ST NE
CULLMAN, AL 35055-1953
Phone number: 256-734-3202
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Mailing Address
JUSTIN WILSON CRNP
503 CLARK ST NE
CULLMAN, AL 35055-1921
Phone number: 256-739-0801
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