Individual
TRACIE E WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3198 W COUNTY ROAD 500 N, GREENSBURG, IN 47240-9757
(812) 593-5485
(812) 663-8632
Mailing address
3198 W COUNTY ROAD 500 N, GREENSBURG, IN 47240-9757
(812) 593-5485
(812) 663-8632
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
8918-41-7119
IN
Other
Enumeration date
04/28/2009
Last updated
04/28/2009
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