Individual
JOEL WYSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1645 W BETHANY HOME RD, PHOENIX, AZ 85015-2507
(602) 249-3057
(602) 249-1420
Mailing address
11103 WEST AVE, STE 6, SAN ANTONIO, TX 78213-1370
(210) 524-6803
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
263
AZ
Other
Enumeration date
12/20/2006
Last updated
07/09/2007
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