| NPI | 1992944979 |
|---|---|
| Other Name | DR. KAMRIAN SUE WILSON OD |
| Entity Type | Organization |
| Authorized Contact | NANCY EILEEN SUTTON Front Office Manager 573-336-4670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MO TO3060) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2009-02-13 |