Individual
AMANDA C WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
113 BO BO DR, CRYSTAL SPRINGS, MS 39059-2741
(601) 892-4121
Mailing address
1009 KERN LN, CRYSTAL SPRINGS, MS 39059-8765
(601) 906-7887
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
T-08901
MS
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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