Individual
REGINA RYLEE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1733 DAWSON ST, WILMINGTON, NC 28403-2326
(910) 392-5806
(910) 397-2867
Mailing address
1733 DAWSON ST, WILMINGTON, NC 28403-2326
(910) 392-5806
(910) 397-2867
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
000822573
NC
Other
Enumeration date
12/23/2009
Last updated
12/23/2009
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