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General NPI Number Information
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NPI Number | 1255447033
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Entity Type | Organization
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Legal Business Name | ADAM L. WILDING, D.C., P.C.
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 140 PROFESSIONAL CIR
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-3374
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Country | US
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Telephone | 757-220-9670
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Fax | 757-564-1197
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Provider Business Mailing Address
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Address Line | 140 PROFESSIONAL CIR
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-3374
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Country | US
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Telephone | 757-220-9670
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Fax | 757-564-1197
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ADAM LEWIS WILDING
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Credential | D.C.
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Telephone | 757-220-9670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104002050
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License Number State | VA
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