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
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