Individual
CRYSTAL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1031 WILMINGTON RD, TURKEY, NC 28393-8405
(910) 379-3675
Mailing address
1031 WILMINGTON RD, TURKEY, NC 28393-8405
(910) 379-3675
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
82000291
NC
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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