Individual
WILSON OU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8050 S RAINBOW BLVD, LAS VEGAS, NV 89139-6477
(702) 294-7202
Mailing address
8449 CLEAR AVE, LAS VEGAS, NV 89147-6154
(702) 449-8254
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19076
NV
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
19076
NV
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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