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Individual

DR. AUDREY B.R. VANWYLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2861 BROAD AVE, MEMPHIS, TN 38112-2903
(901) 701-2520
(901) 325-6469
Mailing address
2595 CENTRAL AVE, MEMPHIS, TN 38104-5905
(901) 260-8500
(901) 260-8598

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50473
TN
390200000X
Student in an Organized Health Care Education/Training Program
4301096247
MI

Other

Enumeration date
07/08/2010
Last updated
03/30/2015
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