Individual
MR. JASON WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
15100 GRATIOT AVE, DETROIT, MI 48205-1302
(888) 433-2872
Mailing address
PO BOX 1435, WARREN, MI 48090-1435
(888) 433-2872
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2839100298
MI
Other
Enumeration date
02/15/2013
Last updated
02/15/2013
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