MR. John David Wild JR., DPT

NPI #1508245606 in Ponchatoula, Louisiana

Provider Information

NPI Number: 1508245606
Entity Type: Individual
Name: MR. John David Wild JR., DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: May 21, 2015
Last Updated: May 21, 2015

Practice Location

Address: 510 W PINE ST
City: Ponchatoula
State: Louisiana
ZIP Code: 70454-3738
Phone: (985) 634-1966

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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