Individual
KATRINA WYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1155 COFFEEN ST, WATERTOWN, NY 13601-1843
(315) 782-4700
Mailing address
94220A HOLDENBURY DR, FORT DRUM, NY 13603-3269
(315) 577-2779
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
013282
NY
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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