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Individual

MELISSA WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN, OTC, CPED, BOCO

Contact information

Practice address
611 N LINDSAY ST, SUITE 200, HIGH POINT, NC 27262-4300
(336) 802-2250
(336) 802-2251
Mailing address
1701 WESTCHESTER DRIVE, SUITE 850, HIGH POINT, NC 27262-7254
(336) 802-2536
(336) 802-2534

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
034220
NC
222Z00000X
Orthotist
Primary
BOCO C50277
224L00000X
Pedorthist
ABC CPED 0855

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7795543
NC
Enumeration date
01/03/2012
Last updated
03/12/2015
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