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Individual
MARK R WILSON
Active
Individual
MARK R WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
Q.M.E., O.M.D., LAC
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005109
CA
Other
Enumeration date
12/08/2006
Last updated
03/28/2023
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