Individual
AUSTIN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 E MAIN ST STE F, JACKSON, OH 45640-1787
(740) 286-5677
Mailing address
14 GRANDVIEW AVE, JACKSON, OH 45640-9771
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA012652
OH
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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