Tristan Wilson

NPI #1083184162 in Kansas, Oklahoma

Provider Information

NPI Number: 1083184162
Entity Type: Individual
Name: Tristan Wilson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Nov 30, 2018
Last Updated: Nov 30, 2018

Practice Location

Address: 1119 E TULSA AVE
City: Kansas
State: Oklahoma
ZIP Code: 74347-7055
Phone: (918) 868-6162

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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