Individual
TRACEY JEANNETTE WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1598 E MAIN ST, TORRINGTON, CT 06790-3519
(860) 489-8444
(860) 496-8641
Mailing address
PO BOX 1090, WINDSOR, CT 06095-6190
(203) 709-5935
(203) 709-5942
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
000270
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5002704
—
CT
Enumeration date
01/22/2007
Last updated
10/29/2021
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