Individual
MR. ROBERT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
800 S ASH ST, NEVADA, MO 64772-3223
(417) 448-3728
(417) 448-3724
Mailing address
RR 1 BOX 28B, NEVADA, MO 64772-9841
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
044242
MO
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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