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Individual

MR. JERALD MITCHELL WILES JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1915 WEST PARK DRIVE, PHYSICAL THERAPY ASSOCIATES OF WILKES LLC STE 102, NORTH WILKESBORO, NC 28659
(336) 903-9293
(336) 903-9295
Mailing address
1915 WEST PARK DRIVE, PHYSICAL THERAPY ASSOCIATES OF WILKES LLC STE 102, NORTH WILKESBORO, NC 28659
(336) 903-9293
(336) 903-9295

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2266
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7201007
NC
Enumeration date
07/31/2006
Last updated
07/08/2007
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