Provider Demographics
NPI:1093804155
Name:WILSON, ERIC ROBERT (DC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:ROBERT
Last Name:WILSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7350 W 88TH AVE UNIT G
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6400
Mailing Address - Country:US
Mailing Address - Phone:303-422-9955
Mailing Address - Fax:303-422-3022
Practice Address - Street 1:505 ANGLERS DR
Practice Address - Street 2:STE 102
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8836
Practice Address - Country:US
Practice Address - Phone:970-879-6501
Practice Address - Fax:970-879-6502
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor