Individual
ELAINE WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3437 CAROLINE ST, ROOM 1015, SAINT LOUIS, MO 63104-1111
(314) 977-8538
(314) 977-8513
Mailing address
807 WAYFARER DR, MANCHESTER, MO 63021-7523
(314) 977-8505
(314) 977-8513
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
R0953
MO
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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