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Grant Wilson
NPI 1720624695 · on the registry since 2019 · sole proprietor
Practice
- Address
- 1407 N Michigan St
Plymouth, IN 46563 - Phone
- (574) 941-2220
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 237700000X
237700000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-11-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana