Organization
WYLIE ENTERPRISES, INC
Active
Other names
Providence Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN MICHAEL WYLIE D.C. (OWNER)
(256) 801-7227
Entity
Organization
Contact information
Practice address
100 PROVIDENCE MAIN ST NW, SUITE D, HUNTSVILLE, AL 35806-4826
(256) 801-7227
(256) 361-9942
Mailing address
100 PROVIDENCE MAIN ST NW, SUITE D, HUNTSVILLE, AL 35806-4826
(256) 801-7227
(256) 361-9942
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2421
AL
Other
Enumeration date
11/02/2013
Last updated
01/19/2016
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