Lisa Marie Wilson, PA
NPI #1023399896 in Myrtle Beach, South Carolina
Provider Information
- NPI Number
- 1023399896
- Entity Type
- Individual
- Name
- Lisa Marie Wilson, PA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Credential
- PA
- Enumeration Date
- Sep 7, 2011
- Last Updated
- Mar 20, 2017
Practice Location
- Address
- 809 82ND PKWY
- City
- Myrtle Beach
- State
- South Carolina
- ZIP Code
- 29572-4607
- Phone
- (843) 497-5929
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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