Individual
ESLEEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4520 N RIVER DR, CUMMING, GA 30041-9463
(770) 519-0004
Mailing address
4520 N RIVER DR, CUMMING, GA 30041-9463
(770) 519-0004
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1012391
GA
Other
Enumeration date
08/12/2019
Last updated
08/13/2019
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