Individual
MR. JOHNATHAN LYNN WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2609 FEATHERSTONE RD APT 133, OKLAHOMA CITY, OK 73120-2156
(806) 570-2712
Mailing address
2609 FEATHERSTONE RD APT 133, OKLAHOMA CITY, OK 73120-2156
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/23/2011
Last updated
02/23/2011
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