Individual
LYNNETTE S WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4150 ALABAMA AVE. N.W., NORTH LAWRENCE, OH 44666
(330) 412-8066
Mailing address
PO BOX 26, NORTH LAWRENCE, OH 44666-0026
(330) 412-8066
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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