Individual provider · Type 1 NPI

Koteuaisa Tanswanie Wilson, CH

Chiropractor · Lakeland, FL

NPI number 1295035558 Active

Practice location

202 Lake Miriam Dr Ste W3
Lakeland, FL 33813-2179

Call (863) 647-0808 Map

Fax (863) 250-0715

Specialties and licenses

TaxonomyCodeLicense
Chiropractor Primary 111N00000XCH10077 (FL)

Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

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About NPI 1295035558

Koteuaisa Tanswanie Wilson, CH's National Provider Identifier is 1295035558, issued on Nov 2, 2010. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Lakeland, FL. The record was last updated on Oct 5, 2022.