Individual
AMANDA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
34 W 5TH ST, BUCKEYE LAKE, OH 43008
(740) 281-9617
Mailing address
34 W. 5TH ST., BUCKEYE LAKE, OH 43008
(740) 281-9617
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/31/2015
Last updated
07/31/2015
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