Individual
WYATT EDWARD SHOWLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
827 W 13TH ST, ROCHESTER, IN 46975-2502
(574) 223-0346
Mailing address
827 W 13TH ST, ROCHESTER, IN 46975-2502
(574) 223-0346
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
06004492A
IN
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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