Wilson, Thomas Charles

Wilson, Thomas Charles is an sole proprietor health care provider with primary practice located at 213 State St W , Detroit Lakes MN 56501-3005. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Wilson, Thomas Charles can be contacted via phone (218) 847-4366.

Contact Information

Primary practice address
213 State St W Detroit Lakes MN 56501-3005
Phone: (218) 847-4366
Fax: (218) 847-1838
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 001629 Minnesota

Profile Details

NPI number 1679538565
LBN Legal business name Wilson, Thomas Charles
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 20th, 2006
Last updated Feb 26th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679538565 NPPES
Minnesota Other 49403WI BLUE CROSS/BLUE SHIELD
Minnesota MEDICAID 972327700 BLUE CROSS/BLUE SHIELD
Minnesota Other 410144 BLUE CROSS/BLUE SHIELD

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