National Provider Identifier
Debora Carol Wild, PT
Debora Carol Wild, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Lackawanna, NY and a listed phone number of (716) 819-5036.
Profile Overview
- NPI
- 1235595372
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- January 05, 2016
- Last Updated
- January 05, 2016
Practice Location
- 55 Melroy Ave
- Lackawanna, NY 14218-1658
Phone: (716) 819-5036
Mailing Address
- 59 Frances St
- Tonawanda, NY 14150-4016
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1235595372
- Entity Type
- Individual
- Last Name
- Wild
- First Name
- Debora
- Middle Name
- Carol
- Name Prefix
- MS.
- Credential
- PT
- Mailing Street Address
- 59 Frances St
- Mailing City
- Tonawanda
- Mailing State
- NY
- Mailing ZIP Code
- 14150-4016
- Mailing Country
- US
- Mailing Phone
- (716) 696-2008
- Practice Street Address
- 55 Melroy Ave
- Practice City
- Lackawanna
- Practice State
- NY
- Practice ZIP Code
- 14218-1658
- Practice Country
- US
- Practice Phone
- (716) 819-5036
- Enumeration Date
- January 05, 2016
- Last Updated
- January 05, 2016
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)