Individual provider · Type 1 NPI

Berevon Tayshawn Wyatt

Massage Therapist · Milwaukee, WI

NPI number 1114526068 Active

Practice location

3510 N Oakland Ave Ste 206
Milwaukee, WI 53211-2746

Call (414) 915-4213 Map

Mailing address

1727 W Keefe Ave
Milwaukee, WI 53206-2322

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X14485-146 (WI)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1114526068

Berevon Tayshawn Wyatt's National Provider Identifier is 1114526068, issued on Oct 21, 2020. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Milwaukee, WI. The record was last updated on Oct 21, 2020.