Individual
MRS. AMANDA KAY WYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
2279 GRAY BIRCH CT, AVON, IN 46123-8238
(636) 577-3464
Mailing address
2279 GRAY BIRCH CT, AVON, IN 46123-8238
(636) 577-3464
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002557A
IN
Other
Enumeration date
01/07/2011
Last updated
01/07/2011
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