Female

Ms. Suzette K. Wilson CMA,PCT,LMT

Specialist in Kennesaw, GA(View on Map)

Full Name

Ms. Suzette Karen Wilson CMA,PCT,LMT

NPI Number

1407170475

NPI Type

Individual Provider

Gender

Female

Enumeration Date

03/19/2010

Specialties

(Taxonomies)

Code

174400000X

Primary Taxonomy

Yes

Licenses

State

Georgia

License Number

MT005239

Contact
Information

Purpose

Mailing
Location

Address

4172 SHILOH RIDGE TRL NW
4172 SHILOH RIDGE TRL NW

City

Kennesaw
Kennesaw

State

GA
GA

Postal Code

30144-2160
30144-2160

Country

US
US

Telephone Number

(770) 865-9886
(770) 865-9886

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/19/2010

Provider Address

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