Provider Demographics
NPI:1730238437
Name:WILDING, ARTIE L (DC)
Entity type:Individual
Prefix:DR
First Name:ARTIE
Middle Name:L
Last Name:WILDING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 OLDE TOWNE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1924
Mailing Address - Country:US
Mailing Address - Phone:757-220-0060
Mailing Address - Fax:757-229-3481
Practice Address - Street 1:5252 OLDE TOWNE RD
Practice Address - Street 2:SUITE A
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-1924
Practice Address - Country:US
Practice Address - Phone:757-220-0060
Practice Address - Fax:757-229-3481
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA017078OtherBCBS
VA017078OtherBCBS
VAT21936Medicare UPIN