Kenneth R Wilson SR.
NPI #1619567872 in Jacksonville, Florida
Provider Information
- NPI Number
- 1619567872
- Entity Type
- Individual
- Name
- Kenneth R Wilson SR.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Jan 21, 2021
- Last Updated
- Jan 21, 2021
Practice Location
- Address
- 2081 CHAFFEE RD S LOT 119
- City
- Jacksonville
- State
- Florida
- ZIP Code
- 32221-1887
- Phone
- (904) 834-9093
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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