Individual
MS. ANJANETTE RAYNATA WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
112 JORDAN DR, CHATTANOOGA, TN 37421-6802
(423) 468-4060
(423) 468-4069
Mailing address
6601 GREEN RD, CHATTANOOGA, TN 37421-3657
(423) 503-6865
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000001629
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT0000001629
TN LICENSE NUMBER
TN
Enumeration date
04/14/2014
Last updated
04/14/2014
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