PENNY LAINE WILSON

ROGERS, AR
NPI1700481249
Former NamePENNY LAINE BROWN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: AR  PD10308)
Additional Taxonomies183500000X Pharmacist
(Licence: MO  2018037540)
Enumeration Date2020-12-02
Last Update Date2020-12-02
Business Address
PENNY LAINE WILSON
2252 N 8TH ST
ROGERS, AR 72756-2842
Phone number: 479-621-9188
Mailing Address
PENNY LAINE WILSON
1606 PARK RIDGE WAY
CAVE SPRINGS, AR 72718-8443
Phone number: 479-381-5351