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General NPI Number Information
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NPI Number | 1568777183
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Entity Type | Organization
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Legal Business Name | EDWARD D WILSON DC PA
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 4500 HILLCREST RD 160
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 872-377-4747
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Fax | 972-377-0977
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Provider Business Mailing Address
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Address Line | 4500 HILLCREST RD 160
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 872-377-4747
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Fax | 972-377-0977
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EDWARD D WILSON
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Credential | DC
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Telephone | 972-377-4747
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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 | 7091
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License Number State | TX
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