Individual
DR. SONI WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
15 E KIRBY ST, SUITE 111, DETROIT, MI 48202-4047
(313) 575-2947
Mailing address
15 E KIRBY ST, SUITE 111, DETROIT, MI 48202-4047
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006844
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4840358
—
MI
Enumeration date
07/24/2006
Last updated
03/17/2010
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