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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. WYATT ROBERT WICHMAN

Active Sole Proprietor

MR. WYATT ROBERT WICHMAN is a Physical Therapy Clinic healthcare provider located in GLENDALE, California. NPI 1265072904 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Clinic · GLENDALE, CA

Registration Details

NPI Number
1265072904
Provider Type
Individual
Gender
Male
NPI Issued
Jan 10, 2020 (6.4465094947058 yrs)
Last Updated
Jan 14, 2020
Licenses
03316548 (CA)
03316548 (CA)
Sole Proprietor
Yes

Practice Information

Address
100 W BROADWAY STE 750
GLENDALE, CA, 912101215
Browse CA providers · Browse ZIP 91210
Phone
3234194103
Fax
3234195507
Primary Specialty
Physical Therapy Clinic
261QP2000X
Additional Specialty
Physical Therapy Clinic

Other Physical Therapy Clinic Providers in GLENDALE, CA

Name Credential NPI
MR. ERIC JOHN KAMAKEA M.P.T. 1669504684
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.