Individual
HEATHER KOREN WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 821-8874
(270) 821-8883
Mailing address
PO BOX 614, HOPKINSVILLE, KY 42241-0614
(270) 886-2205
(270) 886-0392
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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