Cheyenne Wilson

NPI #1114471273 in Southfield, Michigan

Provider Information

NPI Number: 1114471273
Entity Type: Individual
Name: Cheyenne Wilson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Aug 6, 2016
Last Updated: Aug 6, 2016

Practice Location

Address: 26836 EMMETT ST
City: Southfield
State: Michigan
ZIP Code: 48033-3626
Phone: (313) 717-0474

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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