Individual
KEISHA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 BUENA VISTA RD, COLUMBUS, GA 31906-3142
(706) 323-7244
(706) 596-0424
Mailing address
2401 BUENA VISTA RD, COLUMBUS, GA 31906-3142
(706) 323-7244
(706) 596-0424
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
056237329
GA
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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