Individual
MICHAEL W WILT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-9300
Mailing address
55 WALKER AVE, BRADFORD, PA 16701-1230
(585) 968-2000
(585) 968-1710
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
011849
NY
Other
Enumeration date
09/27/2006
Last updated
04/02/2021
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