# DR. BRIAN SEAN WILSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1063414720
- **Gender:** Man
- **Credential:** DC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 2674 | OH | Yes |

## Other

- **Enumeration date:** 08/12/2005
- **Last updated:** 09/28/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2057983 | — | OH |