Provider Demographics
NPI:1518563196
Name:WILKINSON, FORREST (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:FORREST
Middle Name:
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 EDGEWOOD RD E
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2404
Mailing Address - Country:US
Mailing Address - Phone:828-279-9845
Mailing Address - Fax:
Practice Address - Street 1:132 BOONE ST STE 8
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-1368
Practice Address - Country:US
Practice Address - Phone:828-279-9845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAC-2034171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist