Individual
KATY WEDGEWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 RICE RD, TYLER, TX 75703-3233
(903) 561-6060
Mailing address
421 S BONNER ST, JACKSONVILLE, TX 75766-2330
(903) 589-9871
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2140818
TX
Other
Enumeration date
08/10/2018
Last updated
08/10/2018
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