Individual
MS. BRENDA E WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6801 LUCY CORR CT, CHESTERFIELD, VA 23832-6657
(804) 748-1227
(804) 717-6659
Mailing address
6801 LUCY CORR CT, CHESTERFIELD, VA 23832-6657
(804) 748-1227
(804) 717-6659
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
2305000634
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004978382
—
VA
Enumeration date
05/13/2008
Last updated
05/13/2008
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