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Individual

TINA MARIE WILCOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1516 DAVISTA AVE, MADISON, OH 44057-1306
(440) 725-1835
Mailing address
1516 DAVISTA AVE, MADISON, OH 44057-1306

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400855680109
OH

Other

Enumeration date
09/06/2012
Last updated
09/06/2012
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