Individual
JOSIE WILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210 E TORRANCE AVE, PONTIAC, IL 61764-2746
(815) 842-1122
(815) 842-2728
Mailing address
210 E TORRANCE AVE, PONTIAC, IL 61764-2746
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043110868
IL
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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