Individual
MR. CARSON RAY WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13677 W MCDOWELL RD, GOODYEAR, AZ 85395-2635
(623) 848-5612
Mailing address
13677 W MCDOWELL RD, GOODYEAR, AZ 85395-2635
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
03/25/2026
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