Individual
MITCHELL WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3450 RICHMOND RD STE 130, LEXINGTON, KY 40509-2742
(859) 224-2273
(859) 224-4675
Mailing address
193 WILLIAM WILDER RD, PINEVILLE, KY 40977-8508
(606) 269-7680
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
281329
KY
Other
Enumeration date
05/26/2023
Last updated
06/06/2023
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