Individual
WESLEY BAILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
5695 HIGHWAY 95 N, LAKE HAVASU CITY, AZ 86404-9646
(928) 764-3755
Mailing address
3601 LOST DUTCHMAN DR UNIT A, LAKE HAVASU CITY, AZ 86406-6825
(928) 486-1573
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO-003427
AZ
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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