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Shannon Wyatt
Prosthetic/Orthotic Supplier in Yorktown, Virginia
NPI 1992151203

Shannon Wyatt is a Prosthetic/Orthotic Supplier based in Yorktown, VA. Shannon Wyatt practices in Yorktown, VA. The NPI Number for Shannon Wyatt is 1992151203 and holds a License No. 1202213935 (Virginia).

The current practice location address for Shannon Wyatt is 400 Commerce Cir, Yorktown, VA and can be reached out via phone at 757-596-2484.

Location: 400 Commerce Cir, Yorktown, VA, 23693-4322
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992151203
Provider Name
Shannon Wyatt
Credential
Provider Entity Type
Individual
Gender
Female
Address
400 Commerce Cir, Yorktown, VA, 23693-4322
Phone Number
757-596-2484
Fax Number
Provider Enumeration Date
05/05/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1202213935 01 VA DPOR
institution
Provider Business Practice Location Address Details
Address
400 Commerce Cir
City
Yorktown
State
Virginia
Zip
23693-4322
Phone Number
757-596-2484
Fax Number
person
Provider Business Mailing Address Details
Address
400 Commerce Cir
City
Yorktown
State
Virginia
Zip
23693-4322
Phone Number
757-596-2484
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
1202213935 (Virginia)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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