Organization
WILDER AND WILDER, LLC
Active
Organization
WILDER AND WILDER, LLC
Active
Other names
Body Energetics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY HUGH WILDER (PRESIDENT)
(910) 695-1177
Entity
Organization
Contact information
Practice address
175 W NEW HAMPSHIRE AVE, SUITE 10, SOUTHERN PINES, NC 28387-4826
(910) 695-1177
Mailing address
175 W NEW HAMPSHIRE AVE, SUITE 10, SOUTHERN PINES, NC 28387-4826
(910) 695-1177
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
893
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
671190671190
BLUE CROSS BLUE SHIELD
NC
Enumeration date
09/27/2009
Last updated
09/27/2009
Update your record
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