Individual
DANIEL WYAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
97 SHERMAN DR, ST JOHNSBURY, VT 05819-9280
(802) 748-3722
(802) 748-1593
Mailing address
97 SHERMAN DR, ST JOHNSBURY, VT 05819-9280
(802) 748-3722
(802) 748-1593
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0000889
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2543
BLUE CROSS BLUE SHIELD VT
VT
Enumeration date
10/11/2006
Last updated
12/09/2011
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