Jason Andrew Wilson, L.Ac. M.S.O.M.
Acupuncturist in Dyer, IN. Individual provider (NPI-1).
NPI number1861651663
StatusActive
Last updated in NPPESNov 18, 2021
Details
- NPI
- 1861651663
- Entity type
- Individual (NPI-1)
- Name
- Jason Andrew Wilson
- Credential
- L.Ac. M.S.O.M.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 5, 2008
- Certification date
- Nov 18, 2021
- Last updated
- Nov 18, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171100000X | Acupuncturist | 198.000780 | IL | Yes |
Practice location
14785 W 101st Ave # 101Dyer, IN 46311-3371
Phone 219-689-5563 · Fax 219-979-5253
Mailing address
14785 W 101st Ave # 101Dyer, IN 46311-3371
Phone 219-689-5563 · Fax 219-979-5253
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