National Provider Identifier
Michael John Wild, MS, ATC, PES
Michael John Wild, MS, ATC, PES is listed in the NPPES registry with a primary specialty of Athletic Trainer in Amherst, NY and a listed phone number of (716) 839-8581.
Profile Overview
- NPI
- 1710390562
- Provider Type
- Individual
- Primary Specialty
- Athletic Trainer
- Enumeration Date
- June 10, 2014
- Last Updated
- June 10, 2014
Practice Location
- 4380 Main St
- Amherst, NY 14226-3544
Phone: (716) 839-8581
Mailing Address
- 5963 Route 98
- PO Box 7
- Great Valley, NY 14741-0007
Specialties
- Athletic Trainer (2255A2300X)
Full Record
- NPI
- 1710390562
- Entity Type
- Individual
- Last Name
- Wild
- First Name
- Michael
- Middle Name
- John
- Credential
- MS, ATC, PES
- Mailing Street Address
- 5963 Route 98
- Mailing Address Line 2
- PO Box 7
- Mailing City
- Great Valley
- Mailing State
- NY
- Mailing ZIP Code
- 14741-0007
- Mailing Country
- US
- Mailing Phone
- (716) 969-7581
- Mailing Fax
- (716) 566-7858
- Practice Street Address
- 4380 Main St
- Practice City
- Amherst
- Practice State
- NY
- Practice ZIP Code
- 14226-3544
- Practice Country
- US
- Practice Phone
- (716) 839-8581
- Practice Fax
- (716) 566-7858
- Enumeration Date
- June 10, 2014
- Last Updated
- June 10, 2014
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Athletic Trainer (2255A2300X)