Individual
WYNEE LOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
720 HOPMEADOW ST, SIMSBURY, CT 06070-2224
(860) 651-3519
(860) 651-4133
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8082
(860) 657-3519
(860) 651-4133
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
069029
CT
207R00000X
Internal Medicine Physician
5101023783
MI
207R00000X
Internal Medicine Physician
BP10047614
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
R1236
TX
Other
Enumeration date
06/11/2013
Last updated
09/29/2022
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