Individual
DR. JOHN DEREK WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1018 E GOODE ST STE 102, QUITMAN, SD 75783
(903) 763-4404
(903) 763-2550
Mailing address
1018 E GOODE ST STE 102, QUITMAN, TX 75783
(903) 763-4404
(903) 763-2550
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7361
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0020166-01
—
TX
Enumeration date
01/10/2007
Last updated
01/12/2024
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