Individual
KAREN LYNN WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
3488 JEFFCO BLVD STE 102, ARNOLD, MO 63010-6015
(636) 464-5439
(636) 464-5438
Mailing address
3488 JEFFCO BLVD STE 102, ARNOLD, MO 63010-6015
(636) 464-5439
(636) 464-5438
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
114477
MO
2251P0200X
Pediatric Physical Therapist
Primary
114477
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
483877411
—
MO
Enumeration date
01/31/2007
Last updated
09/24/2024
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