Individual
MS. CHANDA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2091 SILVER BELL RD APT 46, EAGAN, MN 55122-1045
(612) 223-3449
Mailing address
2091 SILVER BELL RD APT 46, EAGAN, MN 55122-1045
(612) 223-3449
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2023075
MN
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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