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MR. QUINTON WIGGINS WILDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
1590 WILLOW CREEK RD, PRESCOTT, AZ 86301-1164
(928) 227-1899
Mailing address
310 S MOUNT VERNON AVE, PRESCOTT, AZ 86303-4349
(928) 499-7041

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-24842
AZ

Other

Enumeration date
07/07/2020
Last updated
07/07/2020
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