Individual
RODNEY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17602 DEFOREST AVE, CLEVELAND, OH 44128-2606
(216) 921-9457
(216) 921-0446
Mailing address
17602 DEFOREST AVE, CLEVE, OH 44128
(216) 921-9457
(216) 921-0446
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RN473663
OH
Other
Enumeration date
02/12/2009
Last updated
05/20/2009
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