Individual
WYTEKA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
920 OLIVER RD, MONROE, LA 71201-5702
(318) 966-6290
Mailing address
139 OAK CIR, MONROE, LA 71203-2721
(318) 343-3587
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
018655
LA
183500000X
Pharmacist
36417
TX
Other
Enumeration date
10/24/2013
Last updated
10/24/2013
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