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Individual

DR. CRAIG LOUIS WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
26 S MAIN, BOX 279, CEDAR SPRINGS, MI 49319
(616) 696-2650
(616) 696-2650
Mailing address
1272 10 MILE RD, SPARTA, MI 49345
(616) 887-8967
(616) 696-2650

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301004937
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
350045875
RAILROAD MEDICARE #
01
950D150030
BCBS PIN#
01
CW004937
BCBS LICENSE #
Enumeration date
10/25/2006
Last updated
10/13/2010
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