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Individual

AMANDA MOZZO WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
BUILDING 301 ANDREWS AVENUE, FORT RUCKER, AL 36362
(334) 255-7567
Mailing address
BUILDING 301 ANDREWS AVENUE, FORT RUCKER, AL 36362
(334) 255-7567

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
1-109433
AL

Other

Enumeration date
12/10/2020
Last updated
12/10/2020
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