Individual
WYATT JOHN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6628 CLEARWATER CREEK DR, LINO LAKES, MN 55038-7705
(612) 222-8982
Mailing address
6628 CLEARWATER CREEK DR, LINO LAKES, MN 55038-7705
(612) 222-8982
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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