Individual
CARLI WYMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT
Contact information
Practice address
35 MULLINS DR STE 3, LEBANON, OR 97355-3985
(541) 451-6992
Mailing address
35 MULLINS DR STE 3, LEBANON, OR 97355-3985
(541) 451-6992
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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