Individual
TRACI L WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
45 E LOUCKS ST, SUITE 014, SHERIDAN, WY 82801-6339
(307) 655-8055
Mailing address
45 E LOUCKS ST, SUITE 014, SHERIDAN, WY 82801-6339
(307) 655-8055
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
234
MT
Other
Enumeration date
11/19/2009
Last updated
11/19/2009
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