Individual
WANDA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2925 DEBARR RD, SUITE 150, ANCHORAGE, AK 99508-2959
(907) 929-2222
Mailing address
2925 DEBARR RD, SUITE 150, EAGLE RIVER, AK 99577
(907) 843-2633
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
102091
AK
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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