LISA WILDER

LAFAYETTE, IN
NPI1902866502
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36000397A)
Enumeration Date2006-03-27
Last Update Date2007-07-09
Business Address
-- LISA WILDER ATC
2601 FERRY ST
LAFAYETTE, IN 47904-3061
Phone number: 765-448-8000
Mailing Address
-- LISA WILDER ATC
PO BOX 5545
LAFAYETTE, IN 47903-5545
Phone number: 765-448-8000
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