Individual
RYAN WYATT COLLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
524 W MAIN ST, DECATURVILLE, TN 38329-8101
(731) 852-3591
Mailing address
114 WYATT CIR, BATH SPRINGS, TN 38311-1000
(731) 549-5841
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4244
TN
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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