Individual
MS. REBECCA ANNE WILDERMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS ATC CSCS
Contact information
Practice address
10 DOCTORS PARK, GIBSON CITY, IL 60936
(217) 784-2650
(217) 784-8023
Mailing address
301 E WILLOW ST, NORMAL, IL 61761
(309) 862-1786
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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