Tyqwisha Gwynn, OTL | |
2058 Spring Creek Dr, Durham, NC 27704-6110 | |
(919) 667-5593 | |
Not Available |
Full Name | Tyqwisha Gwynn |
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Gender | Female |
Speciality | Occupational Therapist |
Location | 2058 Spring Creek Dr, Durham, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346013794 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 16393 (North Carolina) | Primary |
Provider Name | Legacy Healthcare Services Inc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1104823400 PECOS PAC ID: 2163339722 Enrollment ID: O20170118000750 |
Mailing Address | Practice Location Address |
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Tyqwisha Gwynn, OTL 110 Horizon Dr Ste 310, Raleigh, NC 27615-4926 Ph: () - | Tyqwisha Gwynn, OTL 2058 Spring Creek Dr, Durham, NC 27704-6110 Ph: (919) 667-5593 |
Robin Sheila Munsey, OTD, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 3000 Erwin Rd, Durham, NC 27705 Phone: 919-668-3988 | |
Karen Whitney Wurzinger, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2301 Erwin Rd Rm 6218, Durham, NC 27705 Phone: 919-681-2030 | |
Robbin A. Newton, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: Dumc 3120, Durham, NC 27710 Phone: 919-684-2869 Fax: 919-681-7574 | |
Nancy N. Belding, LPT Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 120 William Penn Plz, Durham, NC 27704 Phone: 919-220-5255 Fax: 919-220-6971 | |
Mrs. Jenny Musselwhite Terry, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3015 Appling Way, Durham, NC 27703 Phone: 919-596-2120 | |
Matthew Forrest Cobb, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2301 Erwin Rd, Durham, NC 27705 Phone: 919-681-2030 | |
Adam Deprimo, MS, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3000 Erwin Rd, Durham, NC 27705 Phone: 919-684-5147 |