Individual
THERESA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-7481
Mailing address
1101 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-7481
Taxonomy
Speciality
Code
Description
License number
State
163WC1400X
College Health Registered Nurse
Primary
60883
MO
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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