Individual
JOANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
206 S DITTMAN ST, FRONTENAC, KS 66763-2253
(615) 896-6400
Mailing address
223 W HWY 160, LAMAR, MO 64759
(417) 499-4643
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-02253
KS
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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