Individual
WYATT H DIMMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Contact information
Practice address
103 PROFESSIONAL PARK DR, CONWAY, SC 29526-9261
(843) 353-3460
Mailing address
528 WARHAWKS RD, CHESAPEAKE, VA 23322-3531
(757) 681-3244
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305217762
VA
225100000X
Physical Therapist
Primary
CP058115T
SC
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/13/2026
Last updated
07/27/2026
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