Individual
ROBERT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
132A N CENTRAL AVE, CENTERVILLE, TN 37033
(931) 729-4001
(931) 729-4081
Mailing address
PO BOX 99, CENTERVILLE, TN 37033-0099
(931) 729-4001
(931) 729-4081
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2591
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366957656
NPPES - PLLC NPI
—
01
—
6128617
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
Enumeration date
05/07/2012
Last updated
06/11/2018
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