Individual
KIMBERLY LYNN WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
710 OBRECHT RD, SYKESVILLE, MD 21784-7650
(410) 804-4803
Mailing address
2625 THORNBROOK RD, ELLICOTT CITY, MD 21042-1748
(443) 472-0083
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4935
MD
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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