Wyatt Ostrum

NPI #1275147589 in North Branch, Michigan

Provider Information

NPI Number: 1275147589
Entity Type: Individual
Name: Wyatt Ostrum
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 3, 2020
Last Updated: Sep 3, 2020

Practice Location

Address: 5190 WILLIS RD
City: North Branch
State: Michigan
ZIP Code: 48461-8969
Phone: (810) 969-1197

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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