Individual
SUSAN MARY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN/LMT
Contact information
Practice address
11911 ARBOR ST, OMAHA, NE 68144-2970
(402) 680-0626
Mailing address
3024 N 125TH ST, OMAHA, NE 68164-2500
(402) 680-0626
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1998
NE
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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