SearchGeorgia374U00000X

Demetirus Wilson

NPI 1699250225 · on the registry since 2018 · sole proprietor

Practice

Address
73 Mallard Hl
Ringgold, GA 30736
Phone
(423) 503-4507

Registry record

Primary taxonomy
374U00000X
374U00000X
Licence states on file
TN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-10-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia