Individual
FELICIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15771 WILDEMERE, SOUTHGATE, MI 48195
(313) 575-0207
Mailing address
15771 WILDEMERE, SOUTHGATE, MI 48195
(313) 575-0207
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703115959
MI
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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