Individual
DR. ALEXIS R WYLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
281 AIRPORT RD, HAZLE TOWNSHIP, PA 18202-3320
(570) 453-2020
Mailing address
312 COUNTRYWOOD DR, HANOVER TOWNSHIP, PA 18706-5311
(570) 606-9234
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG004023
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG004023
PA
Other
Enumeration date
06/27/2023
Last updated
06/29/2023
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