Individual
MICHELLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST, CSFA
Contact information
Practice address
112 S MAIN ST, MILFORD, IN 46542-3006
(574) 832-6246
Mailing address
302 KANSAS DR, GOSHEN, IN 46526-1424
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
129513
IN
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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