Individual
MS. QUINTERRIA TENICIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 MALONE FERGUSON RD, GARNETT, SC 29922-5806
(803) 842-7163
Mailing address
1110 MALONE FERGUSON RD, GARNETT, SC 29922-5806
(803) 842-7163
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN268795
GA
Other
Enumeration date
09/07/2020
Last updated
09/07/2020
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