Individual
DR. GRISELDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2416 WINDSOR SPRING RD, AUGUSTA, GA 30906-4666
(706) 772-7155
Mailing address
4806 GOLDEN LEAF LN, AUGUSTA, GA 30906-8847
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH018959
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00921566A
—
GA
01
—
1148952
NABP NUMBER
GA
05
—
7G8531
—
SC
Enumeration date
05/24/2006
Last updated
07/09/2007
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