Individual
MR. SAMUEL DONNALL WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1114 OAKGROVE AVE, MARTINSVILLE, VA 24112-4811
(336) 520-4381
(276) 595-1185
Mailing address
1114 OAKGROVE AVE, MARTINSVILLE, VA 24112-4811
(336) 520-4381
(276) 595-1185
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T60237004
VA
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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