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1760833719
LAURA WILSON
SPRINGFIELD, IL
NPI
1760833719
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IL 057.004529)
Enumeration Date
2016-06-30
Last Update Date
2016-06-30
Business Address
-- LAURA WILSON C-OTA
2035 W ILES AVE STE C
SPRINGFIELD, IL 62704-4192
Phone number: 800-773-1682
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Mailing Address
-- LAURA WILSON C-OTA
97 EASTGATE DR
WASHINGTON, IL 61571-9271
Phone number: 800-773-1682
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