Individual
DR. MARISA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
2260 BABCOCK BLVD, SUITE 2, PITTSBURGH, PA 15237-3214
(570) 401-1910
Mailing address
2260 BABCOCK BLVD, SUITE 2, PITTSBURGH, PA 15237-3214
(570) 401-1910
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC009474
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11494072
CAQH
—
01
—
DC009474
STATE LICENSE
PA
Enumeration date
04/12/2007
Last updated
06/11/2019
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