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NPI Code Detail

MEDICARE: ANTHONY PAUL WYATT PTA

MEDICARE: ANTHONY PAUL WYATT PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant

General Provider Information

NPI Number : 1568241784
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY PAUL WYATT PTA
Provider Business Mailing Address
First Line : 7 S 10TH AVE
Second Line :
City : YAKIMA
State : WA
Zip : 98902-3318
Country : US
Telephone Number : 509-575-5093
Fax Number : 509-575-5032
Provider Business Practice Location Address
First Line : 7 S 10TH AVE
Second Line :
City : YAKIMA
State : WA
Zip : 98902-3318
Country : US
Telephone Number : 509-575-5093
Fax Number : 509-575-5032
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2023
Last Update Date : 09/26/2023

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Directions to “ ANTHONY PAUL WYATT PTA” Practice Location

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