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1013500503
OCTIVIA WILSON
MULLENS, WV
NPI
1013500503
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2021-02-16
Last Update Date
2021-02-16
Business Address
OCTIVIA WILSON
695 MOUNTAINEER HWY
MULLENS, WV 25882-0255
Phone number: 304-294-8800
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Mailing Address
OCTIVIA WILSON
695 MOUNTAINEER HWY
MULLENS, WV 25882-0255
Phone number: 304-294-8800
Copy
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