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1821295049
DIANE ALICE WILSON
STANBERRY, MO
NPI
1821295049
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
172M00000X Mechanotherapist
(Licence: MO MO00988)
Enumeration Date
2007-06-29
Last Update Date
2007-07-08
Business Address
Mrs. DIANE ALICE WILSON RPT
307 N PINEVIEW ST
STANBERRY, MO 64489-1509
Phone number: 660-783-2118
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Mailing Address
Mrs. DIANE ALICE WILSON RPT
307 N PINEVIEW ST
STANBERRY, MO 64489-1509
Phone number: 660-783-2118
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