# BRIAN R. WILEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1497723365
- **Gender:** Man
- **Credential:** P.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 4676 | SC | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | 4676 | SC | — |

## Other

- **Enumeration date:** 03/08/2006
- **Last updated:** 03/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4676 | PT LICENSE \# | SC |
| 01 | — | 861168971 | EMPLOYER ID\# | SC |