Individual
MADELIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
518 PUJO ST, LAKE CHARLES, LA 70601-4365
(337) 761-5397
Mailing address
1753 ETHEL ST, LAKE CHARLES, LA 70601-5837
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.025514
LA
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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