Individual
THOMAS CHARLES WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
213 STATE ST W, DETROIT LAKES, MN 56501-3005
(218) 847-4366
(218) 847-1838
Mailing address
213 STATE ST W, DETROIT LAKES, MN 56501-3005
(218) 847-4366
(218) 847-1838
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001629
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410144
CHIROPRACTIC CARE OF MN
MN
01
—
49403WI
BLUE CROSS/BLUE SHIELD
MN
05
—
972327700
—
MN
Enumeration date
04/20/2006
Last updated
02/26/2010
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