KODY WYANT

MAYWOOD, IL
NPI1568993038
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)
(Licence: IL  036.159929)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-03-25
Last Update Date2022-05-18
Business Address
KODY WYANT D.O
2160 S 1ST AVE
MAYWOOD, IL 60153-3328
Phone number: 888-584-7888
Mailing Address
KODY WYANT D.O
2160 S 1ST AVE
MAYWOOD, IL 60153-3328
Phone number: