Individual
ASHONDA BELLAMY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1921 INDUSTRIAL PARK RD, CONWAY, SC 29526
(843) 915-8800
Mailing address
1380 HIGHWAY 915, LORIS, SC 29569-9254
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
216526
SC
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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