Individual
LEVI COLTON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2316 17TH ST APT J, PORTSMOUTH, OH 45662-3258
(740) 529-8631
Mailing address
2316 17TH ST APT K, PORTSMOUTH, OH 45662-3258
(740) 529-8631
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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