Individual
OLIVIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
197 BARANOF E, WESTERVILLE, OH 43081-1200
(614) 715-3063
Mailing address
14176 NATIONAL RD SW, ETNA, OH 43068-3363
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
009898
OH
Other
Enumeration date
08/16/2020
Last updated
08/16/2020
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