Individual
AMBER WILSON PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
613 NORTHSIDE DR E, STATESBORO, GA 30458-2194
(912) 489-3008
Mailing address
110 BROOK CIR, GUYTON, GA 31312-6257
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
030112
GA
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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