Individual
DR. JOHN RICHARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1455 YARMOUTH AVE., SUITE 112, BOULDER, CO 80304
(303) 449-7414
(303) 449-2147
Mailing address
1455 YARMOUTH AVE., SUITE 112, BOULDER, CO 80304
(303) 449-7414
(303) 449-2147
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
2311
CO
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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