Individual
JULIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
95 CLEAR SPRING LN, OXFORD, GA 30054-4632
(770) 784-1102
Mailing address
95 CLEAR SPRING LN, OXFORD, GA 30054-4632
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN101389
GA
Other
Enumeration date
11/12/2007
Last updated
11/12/2007
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