# WYATT MEDICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wyatt Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710938444
- **Authorized official:** MS. TRACEY J PODOLSKY MPT, CLT-LANA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (732) 222-8556

## Contact information

- **Practice address:** 504 ALDRICH RD UNIT 1E, HOWELL, NJ 07731-1978
- **Practice address phone:** (732) 222-8556
- **Practice address fax:** (732) 222-8663
- **Mailing address:** 504 ALDRICH RD UNIT 1E, HOWELL, NJ 07731-1978
- **Mailing address phone:** (732) 222-8556
- **Mailing address fax:** (732) 222-8663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | — | NJ | Yes |

## Other

- **Enumeration date:** 05/15/2006
- **Last updated:** 12/05/2020