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1639746092
MIRANDA WILSON
MERIDIAN, ID
NPI
1639746092
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
261QP2000X Clinic/Center, Physical Therapy
(Licence: ID 7420)
Enumeration Date
2021-06-04
Last Update Date
2021-06-04
Business Address
MIRANDA WILSON DPT
2316 S EAGLE RD
MERIDIAN, ID 83642-2665
Phone number: 208-286-2707
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Mailing Address
MIRANDA WILSON DPT
996 E CAYMAN DR
MERIDIAN, ID 83642-6661
Phone number:
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