Individual
MATTHEW CHRISTOPHER WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2151 OLD BRICK RD, GLEN ALLEN, VA 23060-5837
(919) 610-1014
Mailing address
2151 OLD BRICK RD, GLEN ALLEN, VA 23060-5837
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110008094
VA
Other
Enumeration date
11/06/2019
Last updated
12/13/2021
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