MEDICARE: DR. ARVIN R WILSON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	315	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588656086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARVIN R WILSON DC

Provider Business Mailing Address
First Line	:	559 EDGEWOOD PL
Second Line	:
City	:	WHITEFISH
State	:	MT
Zip	:	59937-2358
Country	:	US
Telephone Number	:	406-862-8080
Fax Number	:	406-862-2769

Provider Business Practice Location Address
First Line	:	559 EDGEWOOD PL
Second Line	:
City	:	WHITEFISH
State	:	MT
Zip	:	59937-2358
Country	:	US
Telephone Number	:	406-862-8080
Fax Number	:	406-862-2769

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	07/08/2007

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