Individual
KATHY WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
217 N MOUND ST, NACOGDOCHES, TX 75961-5031
(936) 462-0991
Mailing address
226 W GREENWOOD ST, GARRISON, TX 75946-2427
(936) 462-0991
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
246Z00000X
Other Specialist/Technologist
—
—
Other
Enumeration date
02/09/2024
Last updated
02/10/2024
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