Individual
MS. MARY ALEXANDER WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T,C
Contact information
Practice address
600 S MCKINLEY ST, LITTLE ROCK, AR 72205-5202
(501) 804-5102
Mailing address
1708 N JACKSON ST, LITTLE ROCK, AR 72207-5448
(501) 940-8147
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
010702100
AR
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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