Individual
COURTNEY WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WELLNESS COACH
Contact information
Practice address
2816 E JACKSON ST, SUITE C, HUGO, OK 74743-4250
(580) 326-5350
(580) 326-5320
Mailing address
107 S HIGH ST, ANTLERS, OK 74523-3818
(580) 298-2830
(580) 298-6723
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100744370
—
OK
Enumeration date
04/27/2017
Last updated
04/27/2017
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