Most Relevant Information
Provider Data
| NPI Number: | 1003644899 |
| Provider Name: | ERIC WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/23/2024 |
| Last Updated: | 07/23/2024 |
Provider Practice Location
2 SE LEE BLVD
LAWTON
OK
735012409
Practice Location Phone/Fax
| Phone: | 5802485780 |
| Fax: |
Provider Mailing Location
602 SW 38TH ST
LAWTON
OK
735056912
Provider Mailing Phone/Fax
| Phone: | 5802485780 |
| Fax: |