Individual
DR. KIERSTEN MARIAH WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
3368 STATE ROUTE 752, ASHVILLE, OH 43103-9009
(740) 983-3500
Mailing address
5050 S WALNUT ST LOT 12, SOUTH BLOOMFIELD, OH 43103-1079
(419) 302-7240
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
05019
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05019
—
OH
Enumeration date
12/02/2020
Last updated
12/02/2020
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