Wyatt, Charles Manson

Wyatt, Charles Manson is an individual health care provider with primary practice located at M-48611 Logistics Ave Joel Health Clinic, Fort Bragg NC 28310-0001. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Wyatt, Charles Manson can be contacted via phone (910) 907-9166.

Contact Information

Primary practice address
M-48611 Logistics Ave Joel Health Clinic Fort Bragg NC 28310-0001
Phone: (910) 907-9166
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 100493 North Carolina

Profile Details

NPI number 1063481018
LBN Legal business name Wyatt, Charles Manson
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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