Individual
SUSAN D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 BEECH ST, TAWAS CITY, MI 48763-8314
(989) 362-8196
(989) 362-0967
Mailing address
PO BOX 406153, ATLANTA, GA 30384-1876
(989) 345-7550
(989) 345-7590
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3501003110
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558375956
—
MI
Enumeration date
07/28/2006
Last updated
01/14/2009
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