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Individual

ELLEN KAY WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CST, FA

Contact information

Practice address
185 QUEEN CITY AVE, MANCHESTER, NH 03101-7121
(603) 663-9541
Mailing address
11 COVENTRY CT, MERRIMACK, NH 03054-3445
(603) 231-1756

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary

Other

Enumeration date
10/10/2012
Last updated
10/10/2012
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