Individual
MR. JEREMY STEVEN WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1400 N 500 E, SUITE 120, LOGAN, UT 84341-2455
(435) 716-2886
Mailing address
1400 N 500 E, SUITE 120, LOGAN, UT 84341-2455
(435) 716-2886
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
300218-4810
UT
Other
Enumeration date
12/12/2006
Last updated
04/08/2016
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