Individual
MICHELLE J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1066 LAUREL CREEK DR, CHESTERTON, IN 46304-9607
(219) 921-0565
Mailing address
1066 LAUREL CREEK DR, CHESTERTON, IN 46304-9607
(219) 921-0565
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26017724A
IN
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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