Individual
REBECCA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1200 E MICHIGAN AVENUE, STE 520, LANSING, MI 48912-1837
(517) 364-5260
(517) 364-5251
Mailing address
804 SERVICE RD, A201, EAST LANSING, MI 48824-7015
(517) 884-2976
(517) 432-3928
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5101017592
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053573048
—
MI
Enumeration date
06/30/2008
Last updated
06/16/2016
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