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Individual

DR. PAMELA EILEEN WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
130 MAPLE AVE, SUITE 7A, RED BANK, NJ 07701-1734
(732) 842-7004
(732) 842-8799
Mailing address
130 MAPLE AVE, SUITE 7A, RED BANK, NJ 07701-1734
(732) 842-7004
(732) 842-8799

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
011256
NY
111NR0400X
Rehabilitation Chiropractor
Primary
3851
NJ
133V00000X
Registered Dietitian

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P413708
OXFORD INS ID#
NJ
Enumeration date
04/08/2007
Last updated
09/16/2013
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