Organization
TARA WILSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA STARR WILSON LPN (LPN)
(513) 655-7275
Entity
Organization
Contact information
Practice address
1028 LOCKMAN AVE, 2, CINCINNATI, OH 45238-4512
(513) 655-7275
Mailing address
1028 LOCKMAN AVE, 2, CINCINNATI, OH 45238-4512
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
157760
OH
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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