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Organization
WILD PHYSICAL THERAPY AND PERFORMANCE
Active
Organization
WILD PHYSICAL THERAPY AND PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE WILDERMUTH DPT,CSCS (FOUNDER)
(818) 515-0434
Entity
Organization
Contact information
Practice address
1 SUPERIOR DR UNIT B, SUPERIOR, CO 80027-8649
(818) 515-0434
Mailing address
18967 W 57TH DR, GOLDEN, CO 80403-3008
(818) 515-0434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/17/2026
Last updated
06/17/2026
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