Raymond James Wilson, ATC, LAT
NPI #1154783082 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1154783082
- Entity Type
- Individual
- Name
- Raymond James Wilson, ATC, LAT
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC, LAT
- Enumeration Date
- Mar 21, 2016
- Last Updated
- Mar 21, 2016
Practice Location
- Address
- 11130 PARKVIEW CIRCLE DR
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46845-1735
- Phone
- (765) 860-5307
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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