Individual
NANCY WYTOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
497 1ST ST, PORT CARBON, PA 17965-1623
(570) 449-8760
Mailing address
497 1ST ST, PORT CARBON, PA 17965-1623
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP001874L
PA
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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