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Individual

MR. JEFFREY LEE WILD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
3411B LAKESHORE RD, SHEBOYGAN, WI 53083-2902
(920) 458-8886
(920) 458-1128
Mailing address
3411B LAKESHORE RD, SHEBOYGAN, WI 53083-2902
(920) 458-8886
(920) 458-1128

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2080-012
WI
111N00000X
Chiropractor
Primary
2080-12
WI

Other

Enumeration date
03/26/2007
Last updated
03/18/2019
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