Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1200X | Ergonomics | 6688 | CA |
Y | 225XE1200X | Ergonomics | 6688 | CA |
N | 2251E1300X | Electrophysiology, Clinical | EK 6 | CA |
N | 226300000X | Kinesiotherapist |
NPI | 1619168960 |
---|---|
Provider Name | Marilynn Patten Wyatt |
First Address | San Diego, CA 92134-1098 |
Second Address | San Diego, CA 92134-1098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2007 |
Last Update Date | 27/02/2015 |