| Doctor Name: | MISS NICOLE SHAREE WILSON |
| NPI Number: | 1093941056 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 4047 |
| Business Practice Address: | 1455 Westfield Ave Sw North Canton, OH - 447204235 |
| Business Phone Number: | 3309667347 |
| Business Fax Number: | |
| Mailing Address: | 4774 Munson St Nw, CANTON |
| State: | OH |
| Postal Code: | 447183634 |
| Phone Number: | 3304940422 |
| Fax Number: | |
| NPI Enumeration Date: | 06/04/2009 |
| NPI Last Update Date: | 03/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | 4047 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| 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. |