Individual
LAUREN BRANDT WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003135RX
OH
363A00000X
Physician Assistant
TL1596
SC
Other
Enumeration date
11/01/2010
Last updated
07/26/2024
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