Most Relevant Information
Provider Data
| NPI Number: | 1003224510 |
| Provider Name: | TODD WYMER LAC |
| Entity Type: | Individual |
| Taxonomy Code: | 171100000X |
| Specialty: | Acupuncturist |
| License Number: | AC165723 |
Most Important Dates
| Enumeration Date: | 07/28/2014 |
| Last Updated: | 07/28/2014 |
Provider Practice Location
1330 SE CESAR E CHAVEZ BLVD
PORTLAND
OR
972144322
Practice Location Phone/Fax
| Phone: | 5032321100 |
| Fax: |
Provider Mailing Location
130 SE 105TH AVE APT B1
PORTLAND
OR
972162955
Provider Mailing Phone/Fax
| Phone: | 5417879301 |
| Fax: |