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Individual

ROBERT WILLIAM WYLIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BC-HIS

Contact information

Practice address
100 LAROSA RD, STE D, LONG BEACH, MS 39560
(228) 863-8050
(228) 863-1693
Mailing address
1114 HICKORY DR, LONG BEACH, MS 39560-3223
(228) 863-8050
(228) 863-1693

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
1080
LA
237700000X
Hearing Instrument Specialist
AL 4079
AL
237700000X
Hearing Instrument Specialist
Primary
HAD 0457
MS

Other

Enumeration date
11/15/2010
Last updated
11/15/2010
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