Healthcare Provider Details

I. General information

NPI: 1326793134
Provider Name (Legal Business Name): CHRISTIAN SPENCER WILSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 6TH AVE
HUNTINGTON WV
25701-2308
US

IV. Provider business mailing address

126 W 2ND AVE
WILLIAMSON WV
25661-3104
US

V. Phone/Fax

Practice location:
  • Phone: 304-666-8182
  • Fax:
Mailing address:
  • Phone: 304-928-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1118
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: