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Individual

SUMMER L WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3501 S MAIN ST, LAMAR, CO 81052-4336
(719) 336-3600
(719) 336-2600
Mailing address
PO BOX 1417, LAMAR, CO 81052-1417
(719) 336-2600
(719) 336-3669

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN0041434
CO

Other

Enumeration date
02/04/2022
Last updated
02/04/2022
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