Individual
MS. JANA LYNN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2156 S LUSTER AVE, SPRINGFIELD, MO 65804-2660
(417) 343-7591
Mailing address
2156 S LUSTER AVE, SPRINGFIELD, MO 65804-2660
(417) 343-7591
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
003287
MO
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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