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1902091937
MARK WILSON
GALLUP, NM
NPI
1902091937
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163WP2201X Registered Nurse, Ambulatory Care
(Licence: NM R41887)
Enumeration Date
2007-09-12
Last Update Date
2007-09-12
Business Address
-- MARK WILSON
516 NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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Mailing Address
-- MARK WILSON
PO BOX 1337
GALLUP, NM 87305-1337
Phone number:
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