Individual
BRYAN WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
141 THOMAS JOHNSON DR, SUITE 180, FREDERICK, MD 21702-4502
(301) 620-7478
(301) 620-7479
Mailing address
7310 RITCHIE HWY 500, GLEN BURNIE, MD 21061-3099
(410) 766-4047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24639
MD
Other
Enumeration date
08/12/2013
Last updated
09/04/2015
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