Individual
HALEY WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1518 BROWN AVE, JEFFERSON CITY, TN 37760-1807
(740) 319-4100
Mailing address
1518 BROWN AVE, JEFFERSON CITY, TN 37760-1807
(740) 319-4100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2784
TN
Other
Enumeration date
04/06/2021
Last updated
12/10/2022
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