Individual
DARCE DANAE WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1300 S COUNTRY CLUB RD, EL RENO, OK 73036-5304
(405) 422-1291
(405) 422-1294
Mailing address
1300 S COUNTRY CLUB RD, EL RENO, OK 73036-5304
(405) 422-1291
(405) 422-1294
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1888
OK
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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