Teresa Rena Wiles Vance, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT010261 Issued in GA

Practice address

659 Auburn Ave NE Ste G18
Atlanta, GA 30312-1977

Phone

(470) 322-5619

NPI assigned

Nov 7, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1477198018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1578 VAN VLECK AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162150",
            "telephone_number": "703-473-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 AUBURN AVE NE STE G18",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121977",
            "telephone_number": "470-322-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES VANCE",
        "first_name": "TERESA",
        "middle_name": "RENA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT010261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Sharon Wilder, PH.D.
• Lois Wilder, PA-C
• Joanna Wilen
• Amy Claire Wilensky, SLP
• Haley Wilensky, PT, MPT
• Mairi Dean Wiles, CNM
• Wiley a. Parker M.D PC
• Wiley a. Parker, M.D.,P.C.
• Chandra Wiley
• Courtney Paige Wiley, MD

• Massage Therapist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.