Individual
TINA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 S STATE ROAD 57, WASHINGTON, IN 47501-4326
(812) 254-0200
Mailing address
131 ENTERPRISE RD, JOHNSTOWN, NY 12095-3326
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
17001301A
IN
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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