Individual
STEVEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11011 VILLAGE SQUARE LN, FISHERS, IN 46038-4559
(317) 827-8052
Mailing address
12363 CARRIAGE STONE DR, FISHERS, IN 46037-8416
(765) 725-0096
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002533A
IN
Other
Enumeration date
04/19/2020
Last updated
04/19/2020
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