Individual
EMMA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-5123
Mailing address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-5123
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2568
MN
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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