Individual
AMANDA J WYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
601 JEFFERSON RD, SOUTH CHARLESTON, WV 25309-1636
(304) 395-0682
Mailing address
26 SITTING BULL DR, SAINT ALBANS, WV 25177-3340
(304) 395-0682
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
WV
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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