Individual
MICHELLE LEIGH WYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
283 HARMON LN, LAKE CITY, TN 37769-5338
(865) 426-9481
Mailing address
283 HARMON LN, LAKE CITY, TN 37769-5338
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000001652
TN
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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