Individual
MRS. NYASUNU WI HEPBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1600 BALLEWTOWN RD, BLUE RIDGE, GA 30513-5337
(706) 309-7005
Mailing address
6 GLENNVALE CT, COLUMBIA, SC 29223-7072
(940) 285-0915
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00306700
NJ
Other
Enumeration date
07/30/2014
Last updated
02/25/2022
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