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Individual

PAMELA R. WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
402 MAIN ST, STOCKTON, KS 67669-1930
(785) 425-7172
(755) 425-6611
Mailing address
1630 HIGHWAY 183, STOCKTON, KS 67669-8863
(785) 425-7257

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
14-00126
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14-00126
PHARM. TECH STATE LICENSE
KS
Enumeration date
01/24/2007
Last updated
07/08/2007
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