Individual
KIMBERLY WAYNE HAYWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9 MAPLE TREE CT, SUITE A, GREENVILLE, SC 29615-4070
(864) 286-8288
(864) 286-8289
Mailing address
10 LAKE RIDGE DR, GREENVILLE, SC 29611-6642
(864) 979-8406
(864) 286-8289
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2712
SC
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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