Individual
PRISCILLA MARK-WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3350 NOOR WAY, DOUGLASVILLE, GA 30135-8172
(404) 981-9111
Mailing address
3350 NOOR WAY, DOUGLASVILLE, GA 30135-8172
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/29/2019
Last updated
06/29/2019
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