Individual
DR. DANIEL GEORGE WILCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, MSR
Contact information
Practice address
221 N MAIN ST, LAS CRUCES, NM 88001-1274
(575) 652-6433
Mailing address
221 N MAIN ST, LAS CRUCES, NM 88001-1274
(575) 652-6433
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
—
—
175L00000X
Homeopath
—
—
225100000X
Physical Therapist
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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