Individual
MS. CONNIE JEAN WILDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
615 S. NEW BALLAS RD, ST. LOUIS, MO 63141-8221
(314) 251-4998
(314) 251-7247
Mailing address
615 S. NEW BALLAS ROAD, ST. JOHN'S MERCY MEDICAL CENTER- JFK CLINIC, ST. LOUIS, MO 63141-8277
(314) 251-4998
(314) 251-7247
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2001024181
MO
Other
Enumeration date
04/02/2009
Last updated
04/02/2009
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