Individual
DANA BRYANT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1302 E 10TH ST, JEFFERSONVILLE, IN 47130-4231
(812) 557-1053
Mailing address
3500 ELK POINTE BLVD, JEFFERSONVILLE, IN 47130-7910
(812) 557-1053
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT20901874
IN
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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