Individual
BRYSON LEE WANDLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
815 E. CESAR CHAVEZ BLVD., SAN LUIS, AZ 85349
(928) 627-3822
Mailing address
3280 N 250 E, NORTH OGDEN, UT 84414-1582
(801) 837-0998
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7850
AZ
Other
Enumeration date
03/12/2020
Last updated
03/12/2020
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