NPI 1164049136

Levi William Wilson, ATC

Practitioner Athletic Trainer Brookhaven, GA

Practice location

Address: 1575 N East Expy NE, Brookhaven, GA 30329-2401
Phone: (543) 740-4758
Mailing address: 390 Apple Ridge 2, Dawsonville, GA 30534-5140

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT002885 (GA)

Other Specialist/Technologist providers in Georgia →

Registry record

NPI: 1164049136
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jun 2020
Record last updated: 25 Jun 2020

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.