Individual
KALENNA JEAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
301 S 1ST ST, HOUSTON, MO 65483-1621
(417) 967-2470
Mailing address
301 S 1ST ST, HOUSTON, MO 65483-1621
(417) 967-2470
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2011011887
MO
Other
Enumeration date
05/09/2011
Last updated
07/21/2022
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