Raquel Shelly Solivan Wilson, IDMT

NPI #1528379732 in Moody Afb, Georgia

Provider Information

NPI Number: 1528379732
Entity Type: Individual
Name: Raquel Shelly Solivan Wilson, IDMT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Military Health Care Provider - Independent Duty Medical Technicians
Credential: IDMT
Enumeration Date: Jun 23, 2010
Last Updated: Nov 8, 2023

Practice Location

Address: 23 MEDICAL GROUP/SGPF 3278 MITCHELL BLVD BLD 900
City: Moody Afb
State: Georgia
ZIP Code: 31699-8273
Phone: (229) 257-4685

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider - Independent Duty Medical Technicians — Independent Duty Medical Technicians	1710I1003X	Primary

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