Individual
KIM M WYSNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
16201 ALLEN RD, SOUTHGATE, MI 48195-7903
(734) 282-0000
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
MI
Other
Enumeration date
03/17/2008
Last updated
03/17/2008
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