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Individual

ALIXANDRIA WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
36 MACKENZIE DR, SAINT JOSEPH, MO 64503-3900
(816) 752-0578
Mailing address
36 MACKENZIE DR, SAINT JOSEPH, MO 64503-3900
(816) 752-0578

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
KS

Other

Enumeration date
03/07/2022
Last updated
03/07/2022
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