Most Relevant Information
Provider Data
| NPI Number: | 1003570516 |
| Provider Name: | KENNETH DWAYNE WYRICK |
| Entity Type: | Individual |
| Taxonomy Code: | 374U00000X |
| Specialty: | Home Health Aide |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/30/2021 |
| Last Updated: | 11/05/2021 |
Provider Practice Location
1445 N STATE ROUTE 201
CASSTOWN
OH
453129548
Practice Location Phone/Fax
| Phone: | 1937418452 |
| Fax: |
Provider Mailing Location
1445 N STATE ROUTE 201
CASSTOWN
OH
453129548
Provider Mailing Phone/Fax
| Phone: | 9374184526 |
| Fax: |