Organization
MY CHIROPRACTOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WILSON DC (CEO)
(316) 942-9600
Entity
Organization
Contact information
Practice address
3141 W MAPLE ST, WICHITA, KS 67213-2423
(316) 942-9600
Mailing address
1822 N DENISE MARIE ST, WICHITA, KS 67212-7410
(316) 942-9600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104695
KS
Other
Enumeration date
03/03/2015
Last updated
03/03/2015
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