Individual
DR. AMELIA BRYNNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
909 WALNUT ST RM 300, PHILADELPHIA, PA 19107-5211
(215) 503-6215
(215) 955-0677
Mailing address
909 WALNUT ST RM 300, PHILADELPHIA, PA 19107-5211
(215) 503-7118
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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