Individual
DR. JUSTIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1637 S MARKET BLVD, CHEHALIS, WA 98532-3826
(360) 880-6113
Mailing address
1257 BOISTFORT RD, CHEHALIS, WA 98532-9145
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
61001518
WA
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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