Individual
BROOKE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9372 E PICKWICK CIR BLDG 14, TAYLOR, MI 48180-3854
(248) 800-6622
Mailing address
9372 E PICKWICK CIR BLDG 14, TAYLOR, MI 48180-3854
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501006614
MI
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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