Individual
MRS. KIMBERLY MICHELLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P. AND L.A.C.
Contact information
Practice address
1800 COOKS HILL RD, SUITE A, CENTRALIA, WA 98531
(360) 736-2853
(360) 736-4159
Mailing address
1800 COOKS HILL RD, SUITE A, CENTRALIA, WA 98531
(360) 736-2853
(360) 736-4159
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC60241994
WA
225700000X
Massage Therapist
MA13686
WA
Other
Enumeration date
12/08/2006
Last updated
11/23/2011
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