Individual
DAVID DEMETRIUS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, MS
Contact information
Practice address
338 SW MAIN ST, LEES SUMMIT, MO 64063-2340
(816) 600-5483
Mailing address
1627 SW MANOR LAKE DR, LEES SUMMIT, MO 64082-4183
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2019040226
MO
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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