CARLOS MIKKEL WYNN

LAWRENCEVILLE, GA
NPI1124485602
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: GA  OT006330)
Enumeration Date2016-01-28
Last Update Date2016-01-28
Business Address
Mr. CARLOS MIKKEL WYNN OTR/L
545 OLD NORCROSS RD SUITE 100
LAWRENCEVILLE, GA 30046-3389
Phone number: 678-377-2833
Mailing Address
Mr. CARLOS MIKKEL WYNN OTR/L
1550 CORNELL CT
STATHAM, GA 30666-2046
Phone number: 706-817-1663
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