Individual
MAYDIE MACK WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
2148 TANTALLON DR, FORT MITCHELL, KY 41017-2066
(859) 512-8031
Mailing address
2148 TANTALLON DR, FORT MITCHELL, KY 41017-2066
(859) 512-8031
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
011465
OH
Other
Enumeration date
07/25/2008
Last updated
07/25/2008
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