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Individual

MARK WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2300 GREAT NORTHERN AVE STE B, MISSOULA, MT 59808-1726
(406) 549-9100
(406) 549-9151
Mailing address
2801 GREAT NORTHERN LOOP, MISSOULA, MT 59808-1745
(406) 549-9100
(406) 549-9151

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
826
MT

Other

Enumeration date
11/20/2006
Last updated
11/01/2016
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