Janice Wilson

NPI #1215480215 in Loganville, Georgia

Provider Information

NPI Number: 1215480215
Entity Type: Individual
Name: Janice Wilson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Jul 27, 2016
Last Updated: Jul 27, 2016

Practice Location

Address: 4055 BRUSHYMILL CT
City: Loganville
State: Georgia
ZIP Code: 30052
Phone: (770) 334-7396

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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