| Jackie N. Wyland | |
|
Rd 1 Box 147 A Devecchis St Mckee East Freedom PA 16637 | |
| (814) 695-1801 | |
| Not Available |
| Full Name | Jackie N. Wyland |
|---|---|
| Speciality | Dentist |
| Location | Rd 1 Box 147 A, East Freedom, Pennsylvania |
| Authorized Official Name and Position | Jackie Nelson Wyland (OWNER) |
| Authorized Official Contact | 8146951801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackie N. Wyland Rd 1 Box 147 A East Freedom PA 16637-9731 Ph: (814) 695-1801 | Jackie N. Wyland Rd 1 Box 147 A Devecchis St Mckee East Freedom PA 16637 Ph: (814) 695-1801 |
| NPI Number | 1841462462 |
|---|---|
| Provider Enumeration Date | 03/25/2008 |
| Last Update Date | 07/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841462462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS021195L (Pennsylvania) | Primary |