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Organization
WILES & ASSOCIATES 6970 PA
Active
Organization
WILES & ASSOCIATES 6970 PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ANDREW WILES OD (PRESIDENT)
(904) 887-0836
Entity
Organization
Contact information
Practice address
6767 103RD ST, JACKSONVILLE, FL 32210-7135
(904) 887-0836
Mailing address
268 SAINT JOHNS GOLF DR, ST AUGUSTINE, FL 32092-1052
(904) 887-0836
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2139
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078689600
—
FL
Enumeration date
02/07/2008
Last updated
07/02/2014
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