Individual
TODD WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2151 S HIGHWAY 92, SIERRA VISTA, AZ 85635-5282
(520) 335-1615
Mailing address
15 APEX DR, HIGHLAND, IL 62249-1282
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
12331
AZ
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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