Individual
JENNIFER WAYT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
200 W SANTA ANA BLVD, #100, SANTA ANA, CA 92701-4134
(714) 347-0300
Mailing address
2955 CHAMPION WAY, #98, TUSTIN, CA 92782-1243
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 23763
CA
2251P0200X
Pediatric Physical Therapist
Primary
PT 23763
CA
Other
Enumeration date
05/25/2006
Last updated
07/11/2007
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