Individual
MS. AMY SUE WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
316 1/2 LAUREL AVE, PORT CLINTON, OH 43452-1811
(419) 889-9464
Mailing address
316 1/2 LAUREL AVE, PORT CLINTON, OH 43452-1811
(419) 889-9464
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0062118
—
OH
Enumeration date
04/16/2012
Last updated
08/22/2023
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