TARA MICHELLE WYLEY

LAKEVILLE, MN
NPI1073320602
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MN  15219)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2024-12-17
Last Update Date2025-03-21
Business Address
TARA MICHELLE WYLEY
17489 DODD BLVD
LAKEVILLE, MN 55044-6506
Phone number: 952-428-1020
Mailing Address
TARA MICHELLE WYLEY
2925 CHICAGO AVE
MINNEAPOLIS, MN 55407-1321
Phone number: 612-262-5000