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Individual

DAVID ALAN WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
925 E WALL ST, EAGLE RIVER, WI 54521-8720
(715) 479-6413
(715) 479-4621
Mailing address
PO BOX 1059, EAGLE RIVER, WI 54521-1059
(715) 479-4613
(715) 479-4621

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10409-40
WI

Other

Enumeration date
10/22/2012
Last updated
10/22/2012
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