NPI | 1639248149 |
---|---|
Former Legal Business Name | MICHAEL K WILSON DPM INC (OTHER NAME) |
Entity Type | Organization |
Authorized Contact | LANCE E HARDISON Owner Of Corp 405-751-6153 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OK 151) |
Enumeration Date | 2006-11-07 |
Last Update Date | 2022-11-09 |