Organization
WILSON CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS JAMES WILSON DC (OWNER)
(630) 699-3666
Entity
Organization
Contact information
Practice address
450 MILL ST, FONTANA, WI 53125-1242
(262) 373-9024
Mailing address
450 MILL ST, FONTANA, WI 53125-1242
(262) 373-9024
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5035-12
WI
Other
Enumeration date
03/30/2015
Last updated
03/30/2015
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