Provider Demographics
NPI:1356770176
Name:WILKINS CHIROPRACTIC INC.
Entity type:Organization
Organization Name:WILKINS CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-276-1146
Mailing Address - Street 1:4295 GESNER ST
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6646
Mailing Address - Country:US
Mailing Address - Phone:619-276-1146
Mailing Address - Fax:619-276-1246
Practice Address - Street 1:4295 GESNER ST
Practice Address - Street 2:SUITE 2D
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6646
Practice Address - Country:US
Practice Address - Phone:619-276-1146
Practice Address - Fax:619-276-1246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12097111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1235140070OtherNPI