JACK WINFRED WYLIE

COTTONWOOD, AZ
NPI1043255052
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207X00000X Orthopaedic Surgery
(Licence: AZ  23100)
Enumeration Date2006-06-17
Last Update Date2017-03-16
Business Address
-- JACK WINFRED WYLIE MD
450 S WILLARD ST SUITE 105
COTTONWOOD, AZ 86326-6743
Phone number: 928-634-1112
Mailing Address
-- JACK WINFRED WYLIE MD
1200 N BEAVER ST PAYER CREDENTIALING
FLAGSTAFF, AZ 86001-3118
Phone number: 928-773-2559