MS. Susan Wildwood, G.C.F.T.

NPI #1114184652 in Boise, Idaho

Provider Information

NPI Number: 1114184652
Entity Type: Individual
Name: MS. Susan Wildwood, G.C.F.T.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: G.C.F.T.
Enumeration Date: May 21, 2008
Last Updated: Apr 6, 2009

Practice Location

Address: 2533 N 26TH ST
City: Boise
State: Idaho
ZIP Code: 83702-0308
Phone: (208) 433-8365

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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