Individual
CHERYL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
(618) 998-9894
Mailing address
1834 6TH ST S, ROYALTON, IL 62983-2100
(618) 727-0617
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057000988
IL
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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