Individual
DR. EMANUEL DWAYNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
6349 BEACH BLVD, JACKSONVILLE, FL 32216-2707
(904) 400-8258
Mailing address
6349 BEACH BLVD, JACKSONVILLE, FL 32216-2707
(904) 400-8258
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH13648
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OP279
—
FL
Enumeration date
07/28/2021
Last updated
08/02/2022
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