BLAKE LYNN WILSON

LONGVIEW, TX
NPI1568712768
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: OK  89530)
Enumeration Date2012-09-14
Last Update Date2012-09-14
Business Address
-- BLAKE LYNN WILSON CRNA
6580 JUDSON RD
LONGVIEW, TX 75605-7076
Phone number: 800-939-7440
Mailing Address
-- BLAKE LYNN WILSON CRNA
6580 JUDSON RD
LONGVIEW, TX 75605-7076
Phone number: 800-939-7440
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