Provider Demographics
NPI:1033889597
Name:WILSEY, LILLIAN JOSETTE (DC)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:JOSETTE
Last Name:WILSEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:JOSETTE
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:701 E WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-8431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 E WILL ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-8431
Practice Address - Country:US
Practice Address - Phone:918-923-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor