Individual
MRS. AIMY MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1266 SW 50TH ST, SUITE A, LINCOLN CITY, OR 97367-1310
(541) 848-1445
Mailing address
1266 SW 50TH ST, SUITE A, LINCOLN CITY, OR 97367-1310
(541) 848-1445
Taxonomy
Speciality
Code
Description
License number
State
211D00000X
Podiatric Assistant
Primary
COS-NT-10135071
OR
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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