Individual
AXIA LEAH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3645 CAPE CENTER DR, FAYETTEVILLE, NC 28304-4457
(910) 483-9200
(910) 483-5678
Mailing address
3645 CAPE CENTER DR, FAYETTEVILLE, NC 28304-4457
(910) 483-9200
(910) 483-5678
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001006419
NC
Other
Enumeration date
05/05/2016
Last updated
05/05/2017
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