Individual
MR. BILLY WAYNE VANDYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
54 W 3RD AVE, WILLIAMSON, WV 25661-3508
(304) 235-4300
(304) 235-0176
Mailing address
515 DICKENSON ST APT 1, WILLIAMSON, WV 25661-3257
(304) 235-4300
(304) 235-0176
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000652
WV
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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