Individual
DR. RAEQUI WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
343 S MONTEZUMA ST, PRESCOTT, AZ 86303-7022
(928) 445-2900
Mailing address
343 S MONTEZUMA ST, PRESCOTT, AZ 86303-7022
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
13-1353
AZ
Other
Enumeration date
04/04/2013
Last updated
04/04/2013
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