Doctor Name: | DR. BRIAN WILSON |
NPI Number: | 1386738409 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 5736 |
Business Practice Address: | 1565 W Main St 237 Lewisville, TX - 750672611 |
Business Phone Number: | 9729569887 |
Business Fax Number: | 9729569869 |
Mailing Address: | 1565 W Main St, 237 LEWISVILLE |
State: | TX |
Postal Code: | 750672611 |
Phone Number: | 9729569887 |
Fax Number: | 9729569869 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 03/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 5736 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
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. |