Provider Demographics
NPI:1942649397
Name:J. F. WILSON CHIROPRACTIC N.M. LLC
Entity Type:Organization
Organization Name:J. F. WILSON CHIROPRACTIC N.M. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-884-4365
Mailing Address - Street 1:5500 SAN MATEO BLVD NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6299
Mailing Address - Country:US
Mailing Address - Phone:505-884-4365
Mailing Address - Fax:505-884-4265
Practice Address - Street 1:5500 SAN MATEO BLVD NE
Practice Address - Street 2:SUITE 102
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6299
Practice Address - Country:US
Practice Address - Phone:505-884-4365
Practice Address - Fax:505-884-4265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service