Individual
KELLY MILLER WYRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 E MAIN ST, WYTHEVILLE, VA 24382-3300
(276) 228-6200
Mailing address
1137 HUCKLEBERRY RD, CROCKETT, VA 24323-3101
(276) 620-4623
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004189
VA
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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