Individual
JESSICA RAE WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
690 AVON BELDEN RD STE 2C, AVON LAKE, OH 44012
(440) 225-4555
Mailing address
690 AVON BELDEN RD STE 2C, AVON LAKE, OH 44012-2255
(440) 225-4555
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.018202
OH
Other
Enumeration date
10/31/2011
Last updated
07/09/2018
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