Individual
DR. THERESA LYNN WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
729 E PARK PL, JEFFERSONVILLE, IN 47130-4774
(812) 284-6005
Mailing address
729 E PARK PL, JEFFERSONVILLE, IN 47130-4774
(812) 284-6005
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012959
KY
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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