Provider Demographics
NPI:1679139463
Name:THE WILSON APPROACH
Entity Type:Organization
Organization Name:THE WILSON APPROACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:256-682-1763
Mailing Address - Street 1:211 SW MADISON CIR N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-1314
Mailing Address - Country:US
Mailing Address - Phone:256-682-1763
Mailing Address - Fax:
Practice Address - Street 1:2806 16TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-2517
Practice Address - Country:US
Practice Address - Phone:256-682-1763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP4024OtherACUPUNCTURE