Healthcare Provider Details

I. General information

NPI: 1760321996
Provider Name (Legal Business Name): JOSHUA LEWIS BILSLEND
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15960 W HOLLING RD
WOOD RIVER NE
68883-9355
US

IV. Provider business mailing address

15960 W HOLLING RD
WOOD RIVER NE
68883-9355
US

V. Phone/Fax

Practice location:
  • Phone: 405-933-7075
  • Fax:
Mailing address:
  • Phone: 405-933-7075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: