Individual
TRAVIS WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 N EL DORADO PL STE A-150, TUCSON, AZ 85715-4637
(520) 298-7883
Mailing address
10391 E RUSHLIGHT DR, TUCSON, AZ 85748-3804
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5517
AZ
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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