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1427540608
JAIMIE T WYATT
RUSSELLVILLE, AR
NPI
1427540608
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: AR OT-A1367)
Enumeration Date
2018-06-04
Last Update Date
2018-06-04
Business Address
JAIMIE T WYATT OTA
1915 W MAIN ST
RUSSELLVILLE, AR 72801-2725
Phone number: 479-968-1198
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Mailing Address
JAIMIE T WYATT OTA
500 E 3RD ST
RUSSELLVILLE, AR 72801-5204
Phone number: 479-968-1198
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