Individual
LAUREN WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
18 SUMMERLIN PL, SIMPSONVILLE, SC 29680-7152
(207) 807-0930
Mailing address
18 SUMMERLIN PL, SIMPSONVILLE, SC 29680-7152
(207) 807-0930
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5187
SC
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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