Individual
MARY K WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
2305 W 123RD TER, LEAWOOD, KS 66209-1316
(816) 588-2215
Mailing address
2305 W 123RD TER, LEAWOOD, KS 66209-1316
(816) 588-2215
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
2008004871
MO
1835P1200X
Pharmacotherapy Pharmacist
Primary
03-2-25350
OH
Other
Enumeration date
05/02/2007
Last updated
08/06/2013
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