Individual
TAMMY OWEIDA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
161 S LIBERTY ST, POWELL, OH 43065-7619
(614) 306-2494
Mailing address
217 AARON CT, DELAWARE, OH 43015-3334
(740) 417-9221
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
014227
OH
Other
Enumeration date
08/25/2013
Last updated
08/25/2013
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