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1265097562
JONATHON WYATT
SPARTA, TN
NPI
1265097562
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TN 7121)
Enumeration Date
2019-05-02
Last Update Date
2019-05-02
Business Address
JONATHON WYATT PTA
34 GRACEY ST
SPARTA, TN 38583-2046
Phone number: 931-836-2211
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Mailing Address
JONATHON WYATT PTA
5233 PLATEAU RD
CROSSVILLE, TN 38571-2036
Phone number: 931-787-8091
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