Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 1205 | OH |
NPI | 1346326063 |
---|---|
Provider Name | Dr. Joey David Wilcoxon |
First Address | Gallipolis, OH 45631-1637 |
Second Address | Gallipolis, OH 45631-1637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 08/07/2007 |