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Individual

MS. NANCY LYNN WYATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
115 BLARNEY DRIVE, SUITE #202, COLUMBIA, SC 29223
(803) 736-4845
(803) 736-8674
Mailing address
115 BLARNEY DRIVE, SUITE #202 COLUMBIA REHAB. CLINIC, INC., COLUMBIA, SC 29223
(803) 736-4845
(803) 736-8674

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
114
SC

Other

Enumeration date
05/04/2012
Last updated
05/04/2012
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