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

MR. WYATT BLUE, MS, LAT, ATC, CSCS

Active Sole Proprietor

MR. WYATT BLUE, MS, LAT, ATC, CSCS is a Contractor healthcare provider located in CARDIFF BY THE SEA, California. NPI 1346583754 is currently active in the NPPES registry. Verify at CMS.

Contractor · CARDIFF BY THE SEA, CA

Registration Details

NPI Number
1346583754
Provider Type
Individual
Gender
Male
NPI Issued
Apr 3, 2013 (13.36316915733 yrs)
Last Updated
Jan 16, 2014
License
0506246 (NV)
Sole Proprietor
Yes

Practice Information

Address
1732 MACKINNON AVE
CARDIFF BY THE SEA, CA, 920071605
Browse CA providers · Browse ZIP 92007
Phone
6038126913
Primary Specialty
Contractor
171W00000X
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.