Individual
MRS. CHRISTINA LYNN WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9931 OLD US HIGHWAY 62, LEESBURG, OH 45135-9726
(937) 403-4763
Mailing address
9931 OLD US 62, LEESBURG, OH 45135
(937) 403-4763
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.134928-M-IV
OH
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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