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1528379732
RAQUEL SHELLY SOLIVAN WILSON
MOODY AFB, GA
NPI
1528379732
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date
2010-06-23
Last Update Date
2023-11-08
Business Address
RAQUEL SHELLY SOLIVAN WILSON IDMT
23 MEDICAL GROUP/SGPF 3278 MITCHELL BLVD BLD 900
MOODY AFB, GA 31699-8273
Phone number: 229-257-4685
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Mailing Address
RAQUEL SHELLY SOLIVAN WILSON IDMT
23 MEDICAL GROUP/SGPF 3278 MITCHELL BLVD BLDG 900
MOODY AFB, GA 31699-0001
Phone number: 229-257-4685
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