Individual
MRS. KATHERINE WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-2111
(254) 724-2111
Mailing address
PO BOX 847556, DALLAS, TX 75284-7556
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2061960
TX
Other
Enumeration date
03/10/2011
Last updated
03/10/2011
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