Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH 1821 | WA |
NPI | 1073768784 |
---|---|
Provider Name | Dr. John William Wilcox |
First Address | Bellevue, WA 98007 |
Second Address | Bellevue, WA 98007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2008 |
Last Update Date | 21/11/2008 |