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1942712625
ANTWON LOUIES WILSON
LOS ANGELES, CA
NPI
1942712625
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-11-02
Last Update Date
2017-11-02
Business Address
ANTWON LOUIES WILSON
5849 CROCKER ST UNIT L
LOS ANGELES, CA 90003-1311
Phone number: 323-234-4445
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Mailing Address
ANTWON LOUIES WILSON
5826 LIME AVE UNIT A
LONG BEACH, CA 90805-4108
Phone number: 562-303-2110
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