Individual
TERESA MARIE WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
7733 FORSYTH BLVD, SUITE 2300, SAINT LOUIS, MO 63105-1817
(800) 677-1202
Mailing address
1275 TRAILS DR, FENTON, MO 63026-3652
(636) 225-9288
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01401
MO
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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