JOHN C WILDE

FORT COLLINS, CO
NPI1245631712
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO  ACD.0000026)
Enumeration Date2014-09-15
Last Update Date2014-09-15
Business Address
-- JOHN C WILDE MA, LAC
125 CRESTRIDGE ST
FORT COLLINS, CO 80525-3934
Phone number: 970-494-9761
Mailing Address
-- JOHN C WILDE MA, LAC
125 CRESTRIDGE ST
FORT COLLINS, CO 80525-3934
Phone number: 970-494-9761
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