Individual
ROBERT EARL WILDWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
935 KENWOOD AVE, DULUTH, MN 55811-4951
(218) 396-3787
Mailing address
1225 E 11TH ST, DULUTH, MN 55805-1559
(612) 558-7273
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
822435
MN
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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