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1598009771
JASON ERIC WYLIE
DILLSBORO, IN
NPI
1598009771
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32002153A)
Enumeration Date
2012-11-12
Last Update Date
2012-11-12
Business Address
Mr. JASON ERIC WYLIE COTA/L
12803 LENOVER ST
DILLSBORO, IN 47018-9418
Phone number: 812-432-5226
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Mailing Address
Mr. JASON ERIC WYLIE COTA/L
510B PEARL ST
VEVAY, IN 47043-8414
Phone number: 812-801-7590
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