Doctor Name: | DR. ANDREA MICHELLE WILSON |
NPI Number: | 1063467678 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DC |
License Number: | 8388 |
Business Practice Address: | 832 Main St Ste 100 Kerrville, TX - 780285352 |
Business Phone Number: | 8308962273 |
Business Fax Number: | 8308962673 |
Mailing Address: | Po Box 291077, KERRVILLE |
State: | TX |
Postal Code: | 780291077 |
Phone Number: | 8308962273 |
Fax Number: | 8308962673 |
NPI Enumeration Date: | 05/23/2006 |
NPI Last Update Date: | 07/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 8388 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |