Individual
DR. LORNA KATRINA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4699 FOREST DR, COLUMBIA, SC 29206-3159
(803) 787-3080
(803) 738-0070
Mailing address
31519 WINTERPLACE PKWY, SUITE 2, SALISBURY, MD 21804-1894
(410) 749-1545
(410) 742-3707
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1123
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9957
—
SC
Enumeration date
11/01/2006
Last updated
01/29/2008
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