Individual
TRENT WYSOCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1414 KITCHENS ORCHARD RD, FALLING WATERS, WV 25419-3872
(304) 575-2065
Mailing address
1414 KITCHENS ORCHARD RD, FALLING WATERS, WV 25419-3872
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2001-0782
WV
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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