Individual
HOLLY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 E MULBERRY ST, LANCASTER, OH 43130-3166
(740) 687-7360
Mailing address
105 SHADY LN, SOMERSET, OH 43783-1103
(740) 272-2629
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2039
OH
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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