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Individual
TRISTA WYCKOFF
Active
Individual
TRISTA WYCKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0017458
CO
225200000X
Physical Therapy Assistant
0013510
CO
Other
Enumeration date
12/02/2014
Last updated
05/24/2023
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