Individual
MRS. KRISTEN WYRICK
Active
Individual
MRS. KRISTEN WYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004858
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689872822
TRICARE
KY
01
—
532436
ANTHEM
KY
Enumeration date
07/10/2007
Last updated
01/08/2013
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