JOHN DAVID WILD

PONCHATOULA, LA
NPI1508245606
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: LA  08568)
Enumeration Date2015-05-21
Last Update Date2015-05-21
Business Address
Mr. JOHN DAVID WILD DPT
510 W PINE ST
PONCHATOULA, LA 70454-3738
Phone number: 985-634-1966
Mailing Address
Mr. JOHN DAVID WILD DPT
510 W PINE ST
PONCHATOULA, LA 70454-3738
Phone number: 985-634-1966
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