Aniysa Wylie

Individual provider Active NPI Other Technician · Eastpointe, MI

NPI 1235530767 · NPPES record last updated Sep 16, 2014

Key facts

NPI
1235530767
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
15321 Sprenger Ave
Eastpointe, MI 48021-3609
Phone
(734) 205-7522
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X MI Yes

Addresses

Primary practice location

15321 Sprenger Ave
Eastpointe, MI 48021-3609

Mailing address

15321 Sprenger Ave
Eastpointe, MI 48021-3609
Phone (734) 205-7522

Other providers in Eastpointe, MI

All providers in Eastpointe, MI · Other Technician in Michigan

Sources for this page

Verify at the official NPI Registry.