Individual
PETER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4392 INDIANOLA AVE, COLUMBUS, OH 43214-2226
(614) 725-2488
(614) 725-2302
Mailing address
4392 INDIANOLA AVE, COLUMBUS, OH 43214-2226
(614) 725-2488
(614) 725-2302
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
65.000323
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157884
DIPL. AC. (NCCAOM)
—
01
—
65.000323
ACUPUNCTURIST LICENSE # (OHIO STATE MEDICAL BOARD)
OH
Enumeration date
09/13/2018
Last updated
11/09/2022
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