MR. Jeb Riley Wild, DPT

NPI #1497526222 in Gresham, Oregon

Provider Information

NPI Number: 1497526222
Entity Type: Individual
Name: MR. Jeb Riley Wild, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Jan 10, 2024
Last Updated: Jan 10, 2024

Practice Location

Address: 24076 SE STARK ST STE 200
City: Gresham
State: Oregon
ZIP Code: 97030-3376
Phone: (503) 491-1666

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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