Provider Demographics
NPI:1164079349
Name:ARABIE, WILSON J
Entity Type:Individual
Prefix:
First Name:WILSON
Middle Name:J
Last Name:ARABIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 WRIGHT ST APT 42
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1153
Mailing Address - Country:US
Mailing Address - Phone:832-512-4493
Mailing Address - Fax:
Practice Address - Street 1:435 WRIGHT ST APT 42
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1153
Practice Address - Country:US
Practice Address - Phone:832-512-4493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer