Individual
COURTNEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D
Contact information
Practice address
906 E 5TH AVE, CALVERT CITY, KY 42029
(270) 395-4350
Mailing address
257 GRACE NELL DR, PADUCAH, KY 42003-5797
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020221
KY
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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