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Wyatt Blue, MS, LAT, ATC, CSCS
NPI 1346583754 · on the registry since 2013 · sole proprietor
Practice
- Address
- 1732 Mackinnon Ave
Cardiff By The Sea, CA 92007 - Phone
- (603) 812-6913
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- Contractor
171W00000X
- Licence states on file
- NV
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-01-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California