Individual
WILEY SMART MCCREEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1 MERCADO ST STE 202, DURANGO, CO 81301-7307
(970) 764-9400
(970) 764-9449
Mailing address
2112 NW QUIMBY ST APT 542, PORTLAND, OR 97210-2380
(970) 729-0488
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0006628
CO
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/05/2018
Last updated
02/12/2021
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