Individual
MISS DESARE R WILHELM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
104 E. HIGH ST., HICKSVILLE, OH 43526
(419) 789-9602
Mailing address
2995 CR 424, ANTWERP, OH 45813
(419) 789-9602
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.018671
OH
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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