Individual
JESSICA MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4180 ALABAMA AVE NW, NORTH LAWRENCE, OH 44666-9786
(330) 209-2041
Mailing address
4180 ALABAMA AVE NW, NORTH LAWRENCE, OH 44666-9786
(330) 209-2041
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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