Individual
JASON WYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1555 LONG POND RD, ROCHESTER, NY 14626-4122
(585) 723-7683
Mailing address
1555 LONG POND RD, ROCHESTER, NY 14626-4122
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
010762-1
NY
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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