Individual
BRUCE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 JEFFERSON ST, WHITEVILLE, NC 28472-3602
(910) 641-8600
Mailing address
320 JEFFERSON ST, WHITEVILLE, NC 28472-3602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03556
NC
Other
Enumeration date
05/16/2006
Last updated
02/12/2019
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