Individual
KARA ANN WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC,LAT
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 435-2626
Mailing address
PO BOX 276, 1803 HUNTER ST., HUNTERTOWN, IN 46748-0276
(260) 312-7621
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001550A
IN
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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