Ty S Wakefield, MSPT

NPI #1689705758 in Mesquite, Nevada

Provider Information

NPI Number: 1689705758
Entity Type: Individual
Name: Ty S Wakefield, MSPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MSPT
Enumeration Date: Mar 8, 2007
Last Updated: Mar 7, 2012

Practice Location

Address: 1301 BERTHA HOWE AVE
Address 2: SUITE 7
City: Mesquite
State: Nevada
ZIP Code: 89027-7502
Phone: (702) 346-1899

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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