Individual
MS. SUSAN WILDWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
G.C.F.T.
Contact information
Practice address
2533 N 26TH ST, BOISE, ID 83702-0308
(208) 433-8365
(208) 343-3756
Mailing address
PO BOX 6502, BOISE, ID 83707-6502
(208) 383-0390
(204) 343-3756
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/21/2008
Last updated
04/06/2009
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