Individual
DORICE R. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
302 UNIVERSITY PKWY, AIKEN, SC 29801-6302
(803) 641-5000
Mailing address
2014 HELMSDALE LN, AUGUSTA, GA 30909-0117
(706) 664-8176
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TL 1719
SC
Other
Enumeration date
11/03/2011
Last updated
11/04/2011
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