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Individual

TABITHA SUE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
603 ROSARY DR, CORNING, IA 50841
(641) 322-3121
Mailing address
2324 190TH ST, BEDFORD, IA 50833-8233
(712) 621-4164

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD-46015
IA

Other

Enumeration date
04/01/2016
Last updated
07/24/2019
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