Individual
SHAUNA MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, AAS
Contact information
Practice address
5505 US ROUTE 60, SUITE 100, HUNTINGTON, WV 25705-2070
(304) 412-2165
Mailing address
5505 US ROUTE 60, SUITE 100, HUNTINGTON, WV 25705-2070
(304) 412-2165
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1998-0144
WV
Other
Enumeration date
04/07/2010
Last updated
08/15/2012
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