Individual
KELLY AMANDA WYCOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
359 S LANDMARK AVE, BLOOMINGTON, IN 47403-5002
(812) 334-3919
(812) 334-3936
Mailing address
215 SHUMAN BLVD, STE 401, NAPERVILLE, IL 60563-8123
(630) 303-5380
(630) 303-5385
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
17001391A
IN
Other
Enumeration date
11/20/2013
Last updated
01/22/2014
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