Individual
TESA WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 RIVER BLUFF CIR, GEORGETOWN, TX 78626-4617
(325) 450-7863
Mailing address
310 RIVER BLUFF CIR, GEORGETOWN, TX 78626-4617
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT133884
TX
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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