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Individual

DAVID JAMES WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
9900 VALLEY CREEK RD, STE 145, WOODBURY, MN 55125
(651) 734-1123
(651) 734-1109
Mailing address
9900 VALLEY CREEK RD, STE 145, WOODBURY, MN 55125
(651) 734-1123
(651) 734-1109

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4269
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
260J9WI
BLUE CROSS BLUE SHIELD
MN
Enumeration date
02/21/2007
Last updated
07/29/2015
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