Individual
MR. MICAH LOREN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
111 HILLTOP STREET, RUTHERFORD COLLEGE, NC 28671
(828) 874-4293
Mailing address
100 MEDICAL HEIGHTS DR, MORGANTON, NC 28655-5197
(828) 433-4484
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5006984
NC
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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