Provider Demographics
NPI:1669464319
Name:BYRD, WENDY SEWELL (PT,OSC)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SEWELL
Last Name:BYRD
Suffix:
Gender:F
Credentials:PT,OSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36461-0220
Mailing Address - Country:US
Mailing Address - Phone:251-575-1933
Mailing Address - Fax:251-575-2807
Practice Address - Street 1:2071 S ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-8681
Practice Address - Country:US
Practice Address - Phone:251-575-1933
Practice Address - Fax:251-575-2807
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP91539Medicare UPIN