NPI 1104294073

Alex Wilson

Practitioner Other Technician Kennett, MO

Practice location

Address: 1109 Jones St, Kennett, MO 63857-3824
Phone: (573) 888-6454
Fax: (573) 888-2369

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X

Other Technician, Other providers in Missouri →

Registry record

NPI: 1104294073
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Sep 2015
Record last updated: 9 Sep 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.