Individual
MARK ALLEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6706 CHARLESGATE RD, HUBER HEIGHTS, OH 45424-7077
(937) 829-8808
Mailing address
6706 CHARLESGATE RD, HUBER HEIGHTS, OH 45424-7077
(937) 829-8808
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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