Individual
MARCUS BRADLEY WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
100 E UNIVERSITY # 8800, MAGNOLIA, AR 71753-2181
(870) 235-5052
Mailing address
100 E UNIVERSITY # 8800, MAGNOLIA, AR 71753-2181
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/10/2016
Last updated
11/10/2016
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