Tracy Wilde

NPI 1962509018 - Physical Therapist - 225100000X

NPI Details
NPI 1962509018
Gender Female
Enumeration Date 09/20/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
719B SE MAIN ST
SIMPSONVILLE SC, 29681-3237, US
Phone (864) 963-9229
Fax
Business Location
719B SE MAIN ST
SIMPSONVILLE SC, 29681-3237, US
Phone
Fax
Toxanomy
Taxonomy Code 225100000X
License State South Carolina
License Number 1509
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According to our database, Tracy Wilde NPI is 1962509018, taxonomy code is 225100000X and license number is 1509, license state is located at South Carolina. Tracy Wilde physically located at 719b Se Main St, Simpsonville SC, 29681-3237. NPI Number Tracy Wilde has the Individual type.

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1962509018 NPI number is provided on an as is basis without warranty of any kind. 1962509018 is maintained by the National Plan & Provider Enumeration System. The contents of Tracy Wilde are for informational purposes only.