Individual
MRS. AMY JO WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4207 S DEWITT RD, SAINT JOHNS, MI 48879-8200
(989) 224-2495
Mailing address
4207 S DEWITT RD, SAINT JOHNS, MI 48879-8200
(989) 224-2495
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703050554
MI
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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