Individual
MR. BRETT RUSSELL WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16 KAPPLINGER DR, FARWELL, MI 48622-9405
(989) 588-6769
Mailing address
PO BOX 129, FARWELL, MI 48622-0129
(989) 588-6769
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
AS180407234
MI
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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