Individual
JILL SUZANNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
85 PINE ST APT 107, COSHOCTON, OH 43812-1937
(330) 275-0509
Mailing address
1745 CHESTNUT ST, COSHOCTON, OH 43812-1439
(330) 275-0509
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1601943
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1601943
—
OH
Enumeration date
08/22/2022
Last updated
08/22/2022
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