Individual
REBECCA WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(803) 895-8658
Mailing address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(803) 895-6356
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.023548
IL
Other
Enumeration date
05/02/2019
Last updated
04/02/2026
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