Individual
ROBERT E. WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
9134 BRADENTON RD, FORT WAYNE, IN 46835-8892
(260) 715-5906
Mailing address
9134 BRADENTON RD, FORT WAYNE, IN 46835-8892
(260) 715-5906
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
07000599A
IN
Other
Enumeration date
04/03/2009
Last updated
04/03/2009
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