Individual
MADELINE WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E COLLEGE ST, GEORGETOWN, KY 40324-1696
(502) 863-7032
Mailing address
400 E COLLEGE ST, GEORGETOWN, KY 40324-1696
(502) 863-7032
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
KY
Other
Enumeration date
01/29/2019
Last updated
07/22/2019
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