Individual
SHANNON M WYONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2461 S. HALLMARK DR., FLORENCE, SC 29505-3911
(843) 229-5813
(843) 662-3612
Mailing address
PO BOX 12057, FLORENCE, SC 29504-2057
(843) 229-5813
(843) 662-3612
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2106
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0334
—
SC
05
—
TH0289
—
SC
Enumeration date
09/25/2006
Last updated
06/04/2009
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