Individual
MELISSA WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 PARK ST E, ANNANDALE, MN 55302-3060
(320) 274-3737
Mailing address
500 PARK ST E, ANNANDALE, MN 55302-3060
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A792
MN
Other
Enumeration date
11/05/2014
Last updated
11/05/2014
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