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Individual
THOMAS CHARLES WILSON
Active
Individual
THOMAS CHARLES WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001629
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410144
CHIROPRACTIC CARE OF MN
MN
01
—
49403WI
BLUE CROSS/BLUE SHIELD
MN
05
—
972327700
—
MN
Enumeration date
04/20/2006
Last updated
02/26/2010
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