Individual
MRS. GINA MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3149 PINE LAKE DR, MEDINA, OH 44256-9043
(216) 470-6053
Mailing address
3149 PINE LAKE DR, MEDINA, OH 44256-9043
(216) 470-6053
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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