Individual
DR. BRYANT JAMES WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
651 COLLIERS WAY, SUITE 204, WEIRTON, WV 26062-5053
(304) 723-6331
Mailing address
1244 HANLIN WAY, WEIRTON, WV 26062-4335
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0007448
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP0007448
PHARMACY LICENSE
WV
Enumeration date
03/05/2012
Last updated
03/05/2012
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