Individual
MRS. ELIZABETH ANN WILDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7934 N TOWNSHIP ROAD 72B, TIFFIN, OH 44883-8525
(567) 207-8386
Mailing address
7934 N TOWNSHIP ROAD 72B, TIFFIN, OH 44883-8525
(567) 207-8386
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN095901
OH
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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