Individual
KIMBERLY LATRESE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
825 RUNYAN DR, CHATTANOOGA, TN 37405-1225
(423) 875-6723
Mailing address
8944 BROOKHILL DR, HIXSON, TN 37343-1297
(423) 400-4695
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2558
TN
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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