Doctor Name: | DR. MATTHEW ANDREW WILSON |
NPI Number: | 1457595043 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 007172 |
Business Practice Address: | 5938 Ashworth Rd West Des Moines, IA - 502667110 |
Business Phone Number: | 5152254002 |
Business Fax Number: | 8885507916 |
Mailing Address: | 403 E North St, MADRID |
State: | IA |
Postal Code: | 501561145 |
Phone Number: | 5154232084 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2009 |
NPI Last Update Date: | 04/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 007172 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
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. |