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Koteuaisa Tanswanie Wilson, CH
Chiropractor in Lakeland, Florida
NPI 1295035558

Koteuaisa Tanswanie Wilson is a Chiropractor based in Lakeland, FL. Koteuaisa Tanswanie Wilson practices in Lakeland, FL and has the professional credentials of CH. The NPI Number for Koteuaisa Tanswanie Wilson is 1295035558 and holds a License No. CH10077 (Florida).

The current practice location address for Koteuaisa Tanswanie Wilson is 202 Lake Miriam Dr Ste W3, Lakeland, FL and can be reached out via phone at 863-647-0808 and via fax at 863-250-0715.

Location: 202 Lake Miriam Dr Ste W3, Lakeland, FL, 33813-2179
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295035558
Provider Name
Koteuaisa Tanswanie Wilson
Credential
CH
Provider Entity Type
Individual
Gender
Female
Address
202 Lake Miriam Dr Ste W3, Lakeland, FL, 33813-2179
Phone Number
863-647-0808
Fax Number
863-250-0715
Provider Enumeration Date
11/02/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CH10077 01 FL FL MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
202 Lake Miriam Dr Ste W3
City
Lakeland
State
Florida
Zip
33813-2179
Phone Number
863-647-0808
Fax Number
863-250-0715
person
Provider Business Mailing Address Details
Address
202 Lake Miriam Dr Ste W3
City
Lakeland
State
Florida
Zip
33813-2179
Phone Number
863-647-0808
Fax Number
863-250-0715
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
CH10077 (Florida)
Definition
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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