Individual
AMANDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1001 CORMIER RD, GREEN BAY, WI 54304-4404
(920) 499-2608
(920) 593-9512
Mailing address
1001 CORMIER RD, GREEN BAY, WI 54304-4404
(920) 499-2608
(920) 593-9512
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16329-40
WI
Other
Enumeration date
11/08/2011
Last updated
01/12/2016
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