Individual
MRS. CARLA J WYLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
1305 WALKER AVE N.W., GRAND RAPIDS, MI 49504
(616) 490-2914
(616) 419-3147
Mailing address
1305 WALKER AVE N.W, GRAND RAPIDS, MI 49504
(616) 490-2914
(616) 419-3147
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201000819
MI
Other
Enumeration date
12/05/2010
Last updated
12/29/2017
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