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Individual

SETH M WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
4556 QUINCE RD, SENECA, MO 64865
(417) 776-4556
Mailing address
4556 QUINCE RD, SENECA, MO 64865-8037
(417) 776-4556

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
15924
AR
111N00000X
Chiropractor
Primary
2011013813
MO
171100000X
Acupuncturist
15924
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15924
LICENSE
AR
01
1801872304
GROUP NPI
AR
01
2011013813
LICENSE
MO
Enumeration date
12/02/2011
Last updated
10/10/2019
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