Jesse T Wylie ATC

NPI 1396862108 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1396862108
Gender Male
Enumeration Date 03/25/2007
Last Updated 03/10/2015
Entity Type Individual
Active Over 9 years ago
Practice Location
816 BROAD ST
SUITE 17
MERIDEN CT, 06450-4350, US
Phone (203) 238-1334
Fax
Business Location
33 OLD FIELD HILL RD
SOUTHBURY CT, 06488-3836, US
Phone
Fax
Toxanomy
Taxonomy Code 2255A2300X
License State Connecticut
License Number 000119
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According to our database, Mr. Jesse T Wylie ATC NPI is 1396862108, taxonomy code is 2255A2300X and license number is 000119, license state is located at Connecticut. Jesse T Wylie ATC physically located at 816 Broad St, Meriden CT, 06450-4350. NPI Number Jesse T Wylie ATC has the Individual type.

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1396862108 NPI number is provided on an as is basis without warranty of any kind. 1396862108 is maintained by the National Plan & Provider Enumeration System. The contents of Jesse T Wylie ATC are for informational purposes only.