Individual
MRS. AUDREY LAUREN WIRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
444 CLINCHFIELD ST STE 102, KINGSPORT, TN 37660-3859
(423) 212-5966
Mailing address
155 ELMER WALKER RD, JONESBOROUGH, TN 37659-3149
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8604
TN
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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