Individual
MR. THOMAS WALTER WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
1900 S OHIO ST, MARTINSVILLE, IN 46151-3322
(765) 394-2340
Mailing address
1874 E CUMBERLAND TER N, MARTINSVILLE, IN 46151-5937
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26011530A
IN
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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