SHANNON DIANE WYATT

OAK PARK, IL
NPI1992923585
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  096002293)
Enumeration Date2007-04-22
Last Update Date2007-07-08
Business Address
-- SHANNON DIANE WYATT ATC
1145 N HARLEM AVE
OAK PARK, IL 60302-1529
Phone number: 708-386-2086
Mailing Address
-- SHANNON DIANE WYATT ATC
1418 W OLIVE AVE
CHICAGO, IL 60660-4229
Phone number: 773-805-2119
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