Individual
JEFFREY MILTON WILDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1130 SMITH FIELDHOUSE, PROVO, UT 84602-2246
(801) 422-2946
(801) 422-0038
Mailing address
1130 SMITH FIELDHOUSE, PROVO, UT 84602-2246
(801) 422-2946
(801) 422-0038
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
12478352-4810
UT
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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