| NPI | 1053680991 |
|---|---|
| Former Name | ANNIE LEE WILDBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL 14478) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 4726-12) |
| 111N00000X Chiropractor (Licence: MN 5549) | |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2024-04-10 |