Individual
CLIFFORD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6466 KINGS DR, SAINT PAUL, MN 55128-2523
(651) 249-4181
Mailing address
6466 KINGS DR, OAKDALE, MN 55128-2523
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5991
MN
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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