Individual
TIFFANY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2134 SANDY DR, SUITE 9, STATE COLLEGE, PA 16803-2292
(814) 234-8900
Mailing address
2134 SANDY DR, SUITE 9, STATE COLLEGE, PA 16803-2292
(814) 234-8900
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG002883
PA
Other
Enumeration date
11/09/2012
Last updated
11/09/2012
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