Individual
STEPHANIE WYDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2575 N DRAKE RD, KALAMAZOO, MI 49006-1358
(269) 342-0206
Mailing address
2575 N DRAKE RD, KALAMAZOO, MI 49006-1358
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502002920
MI
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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