Individual
MRS. VANESSA KIM WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1700 E 38TH ST, MARION, IN 46953-4568
(765) 674-3321
Mailing address
10554 PRESTBURY DR, INDIANAPOLIS, IN 46236-8200
(317) 823-6199
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03-3-19838
OH
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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