Individual
JOHN THOMPSON BRUTON WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
612 PASTEUR DR, SUITE 404, GREENSBORO, NC 27403
(336) 299-0609
Mailing address
612 PASTEUR DR, SUITE 404, GREENSBORO, NC 27403
(336) 299-0609
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1268
NC
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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