Most Relevant Information
Provider Data
| NPI Number: | 1003362229 |
| Provider Name: | TERRANCE WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 374U00000X |
| Specialty: | Home Health Aide |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/28/2016 |
| Last Updated: | 08/28/2016 |
Provider Practice Location
10912 OLIVET AVE
CLEVELAND
OH
44108
Practice Location Phone/Fax
| Phone: | 2167210679 |
| Fax: |
Provider Mailing Location
10912 OLIVET AVE
CLEVELAND
OH
44108
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |