Wildeman, Jason

Wildeman, Jason is an individual health care provider with primary practice located at 3351 Sw 4Th St , Bentonville AR 72712-9137. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as his primary health care specialty. Wildeman, Jason can be contacted via phone (479) 936-6265.

Contact Information

Primary practice address
3351 Sw 4Th St Bentonville AR 72712-9137
Phone: (479) 936-6265
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OTR 1463 Arkansas

Profile Details

NPI number 1396701520
LBN Legal business name Wildeman, Jason
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396701520 NPPES
Arkansas Other 5W780 BLUECROSS BLUESHIELD

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