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Individual

MARSHA WYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
8845 LORRAINE RD, GULFPORT, MS 39503-5042
(228) 277-1771
Mailing address
8845 LORRAINE RD, GULFPORT, MS 39503-5042
(228) 277-1771

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1595
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1595
LMT
MS
Enumeration date
03/21/2023
Last updated
03/21/2023
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