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1699817791
DUSTIN RAY WILSON
BOWLING GREEN, KY
NPI
1699817791
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: KY AT525)
Enumeration Date
2007-02-13
Last Update Date
2007-07-08
Business Address
-- DUSTIN RAY WILSON MS ATC CSCS
WESTERN KENTUCKY UNIVESITY ATHLETIC TRAINING 1605 AVENUE OF CHAMPIONS
BOWLING GREEN, KY 42101-6412
Phone number: 270-745-6029
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Mailing Address
-- DUSTIN RAY WILSON MS ATC CSCS
130 OLD SCOTTSVILLE LOOP 1 RD
GLASGOW, KY 42141-8750
Phone number: 270-745-6029
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