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1114582483
REBECCA WILDER
SHAW AFB, SC
NPI
1114582483
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070.023548)
Enumeration Date
2019-05-02
Last Update Date
2023-08-03
Business Address
REBECCA WILDER DPT
420 POLIFKA DR
SHAW AFB, SC 29152-5100
Phone number: 803-895-8658
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Mailing Address
REBECCA WILDER DPT
420 POLIFKA DR
SHAW AFB, SC 29152-5100
Phone number: 803-895-8658
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