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Berevon Tayshawn Wyatt
Massage Therapist in Milwaukee, Wisconsin
NPI 1114526068

Berevon Tayshawn Wyatt is a Massage Therapist based in Milwaukee, WI. Berevon Tayshawn Wyatt practices in Milwaukee, WI. The NPI Number for Berevon Tayshawn Wyatt is 1114526068 and holds a License No. 14485-146 (Wisconsin).

The current practice location address for Berevon Tayshawn Wyatt is 3510 N Oakland Ave Ste 206, Milwaukee, WI and can be reached out via phone at 414-915-4213.

Location: 3510 N Oakland Ave Ste 206, Milwaukee, WI, 53206-2322
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114526068
Provider Name
Berevon Tayshawn Wyatt
Credential
Provider Entity Type
Individual
Gender
Male
Address
3510 N Oakland Ave Ste 206, Milwaukee, WI, 53206-2322
Phone Number
414-915-4213
Fax Number
Provider Enumeration Date
10/21/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3510 N Oakland Ave Ste 206
City
Milwaukee
State
Wisconsin
Zip
53211-2746
Phone Number
414-915-4213
Fax Number
person
Provider Business Mailing Address Details
Address
3510 N Oakland Ave Ste 206
City
Milwaukee
State
Wisconsin
Zip
53211-2746
Phone Number
414-915-4213
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
14485-146 (Wisconsin)
Definition
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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