Individual
WILDA PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
92 RATLIFF ST, LUCEDALE, MS 39452-6537
(601) 673-6383
Mailing address
69 JANE DR, LUCEDALE, MS 39452-6055
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E08330
MS
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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