Individual
PAULINE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
196 PARKWAY S, WATERFORD, CT 06385-1234
(860) 447-0417
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 365-6553
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005293
CT
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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