| Doctor Name: | DENNIS JON WYMAN |
| NPI Number: | 1316946015 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 161632-1205 |
| Business Practice Address: | 175 W 200 S Ste 4009 Salt Lake City, UT - 841011413 |
| Business Phone Number: | 8013597756 |
| Business Fax Number: | |
| Mailing Address: | 175 W 200 S, Ste 4009 SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841011413 |
| Phone Number: | 8013597756 |
| Fax Number: | |
| NPI Enumeration Date: | 07/15/2005 |
| NPI Last Update Date: | 10/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 161632-1205 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |