Individual
JOEL DAVID WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4748 OLD PUMP STREET, WALNUT CREEK, OH 44687
(330) 852-2457
Mailing address
104 W LINCOLNWAY, MINERVA, OH 44657-1436
(919) 802-1322
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
COND.2017480-SP
OH
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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