DR. Bennett Micah Wyllie

NPI #1588001358 in Gladstone, Missouri

Provider Information

NPI Number: 1588001358
Entity Type: Individual
Name: DR. Bennett Micah Wyllie
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chiropractor
Enumeration Date: Jun 3, 2013
Last Updated: Jun 3, 2013

Practice Location

Address: 305 NW ENGLEWOOD CT
Address 2: SUITE 200
City: Gladstone
State: Missouri
ZIP Code: 64118-4072
Phone: (816) 454-5433

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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