Healthcare Provider Details

I. General information

NPI: 1689053621
Provider Name (Legal Business Name): SALINA A. LYTER M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 TORTOISE LN.
HAMLIN WV
25523
US

IV. Provider business mailing address

PO BOX 636
HAMLIN WV
25523-0636
US

V. Phone/Fax

Practice location:
  • Phone: 304-544-8008
  • Fax:
Mailing address:
  • Phone: 304-544-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: