Individual
MR. SAMORY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
153 INDEPENDENCE DR, CARROLLTON, GA 30116-9000
(770) 836-6678
Mailing address
8610 WOOD SPRINGS CT, DOUGLASVILLE, GA 30135-1685
(678) 386-3713
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN223145
GA
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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