MR. Wyatt Blue, MS, LAT, ATC, CSCS
NPI #1346583754 in Cardiff by the Sea, California
Provider Information
- NPI Number
- 1346583754
- Entity Type
- Individual
- Name
- MR. Wyatt Blue, MS, LAT, ATC, CSCS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Contractor
- Credential
- MS, LAT, ATC, CSCS
- Enumeration Date
- Apr 3, 2013
- Last Updated
- Jan 16, 2014
Practice Location
- Address
- 1732 MACKINNON AVE
- State
- California
- ZIP Code
- 92007-1605
- Phone
- (603) 812-6913
Specialties & Taxonomy Codes
| Specialty |
|---|
| Contractor |
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