Individual
WYATT A MACHUPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
202 E CHEYENNE MOUNTAIN BLVD, COLORADO SPRINGS, CO 80906-3769
(719) 527-9331
Mailing address
202 E CHEYENNE MOUNTAIN BLVD, COLORADO SPRINGS, CO 80906-3769
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
0016393
CO
2251X0800X
Orthopedic Physical Therapist
0016393
CO
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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