Individual
MRS. MONDA LEONA WILKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3368 SUFFIELD, COLUMBUS, OH 43232-7530
(614) 323-8106
Mailing address
PO BOX 247592, COLUMBUS, OH 43224-7592
(614) 323-8106
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
374U00000X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2662846
—
OH
Enumeration date
07/31/2014
Last updated
07/31/2014
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