Individual
LARRY WILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2700 E CENTRE AVE, PORTAGE, MI 49002-5500
(269) 286-7050
Mailing address
5943 STADIUM DR, SUITE 3, KALAMAZOO, MI 49009-3016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301058485
MI
Other
Enumeration date
08/30/2006
Last updated
12/10/2020
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