Provider Demographics
NPI:1124357553
Name:DEL WILSON ENTERPRISES, INC.
Entity Type:Organization
Organization Name:DEL WILSON ENTERPRISES, INC.
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELWIN
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PEDORTHIST
Authorized Official - Phone:952-544-3668
Mailing Address - Street 1:14200 WAYZATA BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1746
Mailing Address - Country:US
Mailing Address - Phone:952-544-3668
Mailing Address - Fax:952-544-0668
Practice Address - Street 1:14200 WAYZATA BLVD STE F
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1746
Practice Address - Country:US
Practice Address - Phone:952-544-3668
Practice Address - Fax:952-544-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies