Individual
KRISTAL F. WYATT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
(706) 731-7165
Mailing address
1717 SANDALWOOD DR, AUGUSTA, GA 30909-4343
(706) 736-1742
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT000427
GA
Other
Enumeration date
06/13/2006
Last updated
07/08/2007
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