Individual
MORIAHN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2901 POWDER BASIN AVE, GILLETTE, WY 82718-6406
(307) 682-6222
Mailing address
2901 POWDER BASIN AVE, GILLETTE, WY 82718-6406
(307) 682-6222
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1165639
—
Other
Enumeration date
10/16/2019
Last updated
11/11/2024
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