Individual
CHELSEA DIANNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
515 BLUE BONNET TRL, BONAIRE, GA 31005-3760
(478) 951-3019
Mailing address
515 BLUE BONNET TRL, BONAIRE, GA 31005-3760
(478) 951-3019
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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