Individual
MR. MAURICE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-5060
Mailing address
4234 GRADY RD, MULLINS, SC 29574-5681
(843) 496-6165
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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