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General NPI Number Information
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NPI Number | 1508436668
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Entity Type | Organization
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Legal Business Name | WYLO MEDICAL TRAINING INSTITUTE DBA/ WYLO MEDICAL TRANSPORT
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 07/02/2021
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Provider Practice Location Address
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Address Line | 3328 SPRING VALLEY CT
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-7062
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Country | US
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Telephone | 843-514-8028
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Fax |
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Provider Business Mailing Address
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Address Line | 3328 SPRING VALLEY CT
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-7062
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Country | US
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Telephone | 843-514-8028
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Fax |
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Authorized Official
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Title or Position | CHIEF NURSING OFFICER, OWNER
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Name | CHENEL D LOWRY-WYATT
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Credential | CNO, BSN-RN
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Telephone | 843-514-8028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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