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1235631979
BLAIRE WYATT
SAN ANTONIO, TX
NPI
1235631979
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX 5662)
Enumeration Date
2018-03-07
Last Update Date
2021-08-30
Business Address
BLAIRE WYATT MS, ATC, LAT, CES
1 UNIVERSITY WAY
SAN ANTONIO, TX 78224-3134
Phone number: 210-784-5514
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Mailing Address
BLAIRE WYATT MS, ATC, LAT, CES
4710 LORELEI DR
SAN ANTONIO, TX 78229-5036
Phone number: 816-507-0442
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