Individual
MARY LOU WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4033 PRICE RD, MALTA, OH 43758-9715
(740) 651-3188
Mailing address
202 HIGHLAND DR, NEW LEXINGTON, OH 43764-1420
(740) 651-3188
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
OH
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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