Individual
TRENT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 CROSSWIND DR RM P, FAIRMONT, WV 26554-9162
(681) 214-6390
(304) 906-2444
Mailing address
79 GRACE LN, MORGANTOWN, WV 26508-2606
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0009253
WV
Other
Enumeration date
10/27/2020
Last updated
09/25/2023
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