Individual
ELAINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 MAPLE HILL AVE STE 1, PETERSBURG, WV 26847-1547
(304) 257-9297
Mailing address
401 WALNUT ST, WESTERNPORT, MD 21562-1221
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
05/05/2021
Last updated
05/05/2021
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