Individual
TOM WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7540 N 19TH AVE, STE 200, PHOENIX, AZ 85021-7967
(602) 324-6500
Mailing address
7540 N 19TH AVE, STE 200, PHOENIX, AZ 85021-7967
(602) 324-6500
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-0552
NM
Other
Enumeration date
05/04/2017
Last updated
05/04/2017
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