Individual
MRS. LAURIE KIMBRELL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 TOM HALL ST, FORT MILL, SC 29715-2035
(803) 547-5586
Mailing address
2024 HOLBROOK RD, FORT MILL, SC 29715-9668
(803) 547-5603
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6963
SC
Other
Enumeration date
01/31/2011
Last updated
01/31/2011
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