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1326269739
JACK ANTHONY WILDER
OLYMPIA, WA
NPI
1326269739
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2251X0800X Physical Therapist, Orthopedic
(Licence: WA PT00009619)
Enumeration Date
2007-05-01
Last Update Date
2007-07-08
Business Address
Mr. JACK ANTHONY WILDER PT
405 BLACK HILLS LN SW SUITE G
OLYMPIA, WA 98502-8661
Phone number: 360-956-2562
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Mailing Address
Mr. JACK ANTHONY WILDER PT
4701 77TH CT SE
OLYMPIA, WA 98501-9697
Phone number: 360-455-9068
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